Community Emergency Response Team - Instructor Application

Thank you for your interest in sharing your knowledge and experience to help train CERT members to better prepare themselves, their families, neighbors and community for emergencies.

Please follow the instructions below to complete your application to join our team of CERT Instructors.

Review CERT Instructor Guide to determine CERT Basic Training Units you are interested and able to instruct. See Resources below.
Complete this CERT Basic Training Instructor Interest Form.
Once submitted, your form will be reviewed and you will be contacted.

Any Questions? mailto:Outreach.DEMA@delaware.gov

RESOURCES: To learn specific requirements for each unit:

Unit Summaries – CERT Basic Training Content - provides summary required content for each Basic Training Unit.

Curriculum - CERT Basic Training Instructor Guide - provides detailed unit content, timetable, activities. and instructor expectations

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Service Experience Please select all that apply

Certified/ Licensed Emergency Medical Skills Please indicate all that apply.

Familiarity with CERT - Have you participated/ worked with CERT?

Have you completed IS-317.A: Introduction to Community Emergency Response Team (CERTs)?

CERT Basic Training Units Please check all units you want to be considered to instruct. (see curriculum guides at top of page)

Please indicate Other or Supplemental/ Advanced Training you could provide:

Geographic Availability I am available to conduct CERT presentations in.....Please check all that apply.

General Availability Preference - Please indicate all available. Add specific preferences in "Other".

Are you a registered Delaware State Fire School Instructor? Not required to become a CERT Instructor

Please describe your experience utilizing a variety of media and teaching approaches teaching to a diverse group of adult learners with varying abilities and skills, including classroom presentation, hands-on demonstration, and participant demonstration exercises.

Unit Topic Ability Please summarize your training, experience, and abilities to instruct the Units you have selected.

Please share any documentation you would care to share applying to your ability to provide CERT training.

Community Emergency Response Team Instructor Application