CERT Member Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

CERT Member Survey

We are very interested in what you, the members of Denton County CERT, want from the program. Please answer the following questions to help us better understand your involvement and goals as a member of the program.

First Name *

Last Name *

Which of the following statements BEST reflects your interest in being a CERT Member? *

I enjoy CERT for the meetings and social aspects of seeing others. I attend when I am able

I joined to learn how to better protect my family, friends and neighbors. I'm not really interested in being deployed

I am willing to assist as needed, but would feel more comfortable in a Scribe or Rehab assignment

I am prepared to activate when needed, backpack ready, for any assigned position

Other:

Which of the following statements reflects your ability to deploy? *

I can deploy at almost any time

I can only deploy on evenings or weekends

I would only like to deploy during daytime hours

I would be uncomfortable deploying in bad weather

Don't want to deploy

Required

Which of the following statements BEST reflects your desired assignment in an Deployment situation? *

Radio Communicator

Scribe or Rehab

Search, Triage, Rescue

Medical Treatment Area

Other:

About Monthly/Saturday meetings: (You may select more than one) *

I plan to attend monthly meetings

I will attend when the subject matter is interesting to me

I really am not interested in attending regular meetings

I desire to develop my skills with the longer Saturday classes

Can't attend on Saturday's

Required

I want to further my abilities in the following areas: (You may select more than one) *

Damage Assessment I-pad Training

Disaster Psychology

Urban and Rural Search and Rescue

CPR/AED Stop the Bleed Emergency Medical

Other:

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms