Class Registration Lamorinda CERT Class Registration FormYou are about to register for a CERT Basic Training series. You will be taken to a Credit Card Checkout screen after completing this form to submit the non-refundable registration fee. Your credit card statement will show "LMOCERT". Training SessionFall 2024 (Sept 12 - Nov 7)Winter 2025 (Jan 9 - Mar 6) 9 week basic training classFirst Name(required)Provide first name.Last Name(required)Last NmaeNicknameWhat do we call you? For instance, Elizabeth, Liz or Betty.What do we call you? For instance, Elizabeth, Liz or Betty.Email address(required)Home Phone 999-999-9999Home phone with area code. Include dashes. Do not enter your cell phone number, please. Cell Phone 999-999-9999(required)Only digits.Cell number with area code. Work Phone 999-999-9999 x99999Work phone with area code and extension. Do not enter your cell phone number, please. Address(required)Street Address, not PO BOXCity(required)LAFAYETTEMORAGAORINDACANYONSARANAPBRIONESEL CERRITOKENSINGTONOut of DistrictZip(required)ZIP or ZIP+4 code OccupationDisaster related skillsList any skills, medical, construction, communications, etc. that you can bring following a disaster.List any skills that you have that could be useful following a disaster.Tools & EquipmentInclude pickup truck, chainsaw, winch, etc.List any tools or equipment that you have that could be useful following a disaster.GMRS LicenseIf you have a GMRS radio license for your household, enter your Call Sign.HAM LicenseIf you have a HAM radio license, enter your Call SignAccess and Functional NeedsLamorinda CERT will make accommodation for all people with Access and Functional Needs. Please give us a brief summary of anything you need to make the class series work for you. We will do our best to accommodate you.CommentRegisterThis field should be left blank