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CERT Support Request

Requests for Navarre CERT support at community events should be submitted at least ONE MONTH before the event. Items marked with an asterisk (*) and in BOLD are required entries. Any additional information for your event must be provided at least five (5) days in advance of the event start date. You can send the information via email to info@navarrecert.org, or via the USPS to Navarre CERT, 8688 Navarre Parkway, #362, Navarre, FL 32566.
Note that this is a multi-page form, so make sure you have filled out all of the REQUIRED items before submitting.

General Information

Your Full Name:(*)
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Your Organization:(*)
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Your E-mail:(*)
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Event Name:(*)
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Event Location:(*)
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What will be done with the proceeds from your event?(*)
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Contact Information

Event Point of Contact:(*)
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Home Phone:
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Work Phone:
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Cell Phone:
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Preferred Contact Method:(*)
Please choose a preferred contact method

 

Event Information

Event Start Date and Time:
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Event End Date and Time:
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CERT Start Time:
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CERT End Time:
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Sheriff arrangements:
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EMT Arrangements:
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Security Arrangements:
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Additional Event Information

CERT Duties:(*)
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Event Rules:
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Any additional comments:
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Verify that you are a real person
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