Fillable ATTACHMENT D Community Emergency Response Teams Arizona Department (Arizona)

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ATTACHMENT D Community Emergency Response Teams Arizona Department (Arizona)

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ATTACHMENT D – Community Emergency Response Teams
Arizona Department of Emergency and Military Affairs
Adjunct Instructor Application
Applicant First Name:
Applicant Last Name:
Phone number:
This attachment is to be completed for those who are interested in teaching, and have experience in Public
Information and External Affairs. Successful applicants will be able to instruct the following FEMA courses.
G-317 – Basic Community Emergency Response Team (CERT) (40-Hour)
G-427 – CERT Program Manager (24-Hour)
G-428 – CERT Train-the-trainer (24-Hour)
Programs may also include Teen CERT, Campus CERT, and CERT supplemental training
In addition to the requirements found on Page 1 of the General Instructor Application, in order to be considered to
instruct courses in this track, applicants must provide:
Required Documents (submit in this order, along with the Adjunct Instructor General Application).
This Cover Sheet – Attachment D: Community Emergency Response Teams (CERT)
Biography describing your background and experience with local CERT programs. Bio should include:
CERT membership/affiliation (team name)
CERT responsibilities spanning the past 2 years
Note: Only those currently serving on, or working with CERT teams will be considered for adjunct instructor positions.
All others may be used as secondary or unit instructors at DEMA’s discretion. Biography should include a “Statement
of Currency” detailing how your responsibilities provide you with the opportunity to remain current as a CERT
member.
Recommendation from your employer or CERT program manager, vouching for your overall experience and
role in CERT programs.
Certificates of Completion for the following:
IS-22 – Are You Ready? An In-depth Guide to Citizen Preparedness (online)
IS-317 – Introduction to CERT (online)
G-317 – Basic CERT Training
G-428 – CERT Train-the-trainer
G-427 – CERT Program Manager
Recommended Additional Documents or Coursework.
Completion Certificates for:
Any supplemental CERT training
DEMA may send applicants to a Train-the-Trainer program if otherwise qualified and eligible for this track.
Note: DEMA, Training Branch Manager, and the Arizona Citizen Corps Coordinator shall reserve the right to be the
final authority of any individual’s qualification or abilities, and may waive any of the above if experience and
qualifications warrant.
Certificates must be issued by the Federal Emergency Management Agency/Emergency Management Institute,
Center for Domestic Preparedness, Texas Engineer Extension Service, National Wildfire Coordinating Group, or the
Arizona Department of Emergency and Military Affairs.
Recommended Additional Documents or Coursework.
NOTE: All instructor applications must also be approved by the Arizona Department of Homeland Security.
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ATTACHMENT D Community Emergency Response Teams Arizona Department (Arizona)

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Completed 27 January 2021

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