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CERT Interest Form
Please fill out all fields to the best of your ability.
Name
*
First
Last
Year at UM:
*
Freshman
Sophmore
Junior
Senior
Other
Email
*
Phone Number
###
-
###
-
####
I am interested in CERT because...
I heard about CERT:
*
from a current CERT member
at Canesfest
at the SLC or from SLC staff
on the UM website
on a flyer around campus
on Facebook
from Freshman dorm information
from a Google search
Other
Please feel free to ask us questions about CERT in the field below. We will do our best to answer all of your questions.
Do Not Fill This Out
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