1.Name (First and Last)

2.Email address:

3.What CERT Program are you affiliated with?

4.What is your involvement in CERT

Volunteer

Instructor

Program Manager

Other (please specify)

5.What is your experience with online training?

Have previously taken the Online CERT program

Have not taken Online CERT

Plan to take Online CERT

Other

6.For Program Managers, Have you watched the Hybrid CERT Training webinars or submitted for the Hybrid CERT Training Certificate?

I am a volunteer/not required to watch the training videos

I plan to watch the webinars in the future

No

Not Applicable

7.If your state has not signed up for the Hybrid CERT Training- please forward your State CERT Coordinators contact information to: info@nationalcert.org

8.Thank you for your Support. Question?: OnlineCERT@utah.edu or www.OnlineCERT.org