CERT Program Interest Form

CERT Program Interest Form
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Contact Method
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Confirmation
Thank you for your interest in joining the CERT Program!

A member of the Fridley Fire Division will reach out to you after submitting this form.

Contact Information
- John Lindstrom, CERT Program Director: John.Lindstrom@FridleyMN.gov
- Shelby Wolf, Fire Marshal/Assistant Fire Chief: 763-572-3621.
Should be Empty: