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CERT Volunteer Hours
Please submit any volunteer hours completed that were not recorded on a green CERT sign in sheet.
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* Indicates required question
Volunteer Name
*
Your answer
Date
*
MM
/
DD
/
YYYY
Start Time
Time
:
AM
PM
End Time
Time
:
AM
PM
Total Hours
Choose
.5
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
9
9.5
10
10.5
11
11.5
12
Type of Activity
*
Choose
General Membership
Leadership Activity
Management Activity
Emergency Activation
Special Projects
Wildfire Risk Assessment
Basic Training
Other
Brief Description of Activity
Your answer
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