City of Salem

CERT

(Community Emergency Response Team)

"People Helping People"

Course Application Information

Name _________________________________________________

Address _________________________________________________

Phone # Home____________________Cell______________________

                                       E-Mail Address (Optional)____________________________________

The City of Salem Citizen Corps Council will be offering two upcoming CERT Courses. One course will be offered on Thursday Evenings, another on Saturday Mornings. Please CHECK the one you prefer. Each course will be a 2 hour, 30 minute class for 5 sessions.

Please Check One

Thursday Nights __________ or Saturday Mornings __________

Please bring this application or mail to:     Salem City Hall

                                                                Cert Program

                                                           101 South Broadway

                                                               Salem, IL. 62881

Information Available On City of Salem DOEM Web Site: www.salemdoem.us