The Office of Emergency Services (OES) of the city of Richmond invites and encourages residents of Richmond to take free REACT/CERT emergency preparedness training. Please provide the information below so that we can inform you about these training opportunities.

This form is secure, and your answers will be seen only by OES staff and authorized REACT/CERT volunteers who help us inform the community about classes.

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Contact Information:

First Name*

Last Name*

Home Phone*

Work Phone

Cell Phone

Email Address*

Note: Your physical street address is required for our mapping purposes.

Street Number *

Street Name*

City*

State*

ZIP*

Neighborhood of Richmond in which you live. Please choose from the drop down list at right: *

Not Sure Atchison Village Belding Woods Brickyard Cove Homeowners Association # 1 Brickyard Cove Homeowners Association # 2 Brickyard Landing Homeowners Association Carriage Hills North Homeowners Association Carriage Hills South Homeowners Association Civic Center Improvement Association Coronado Cortez/Stege Countryside Downtown Association of Richmond Eastshore El Sobrante Hills Fairmede Hilltop Greenbriar Green Ridge Heights Hasford Heights Hilltop/Bayview Hilltop Green Homeowners' Association Hilltop Village Homeowners' Association Iron Triangle Laurel Park Marina Bay May Valley North & East Panhandle Annex Parchester Village Park Plaza Parkview Point Richmond Pullman Quail Hill Richmond Annex Richmond Heights Richmore Village Santa Fe Shields-Reid SW Richmond Annex Not Applicable

Please use the space below for additional comments:

Thank you for completing this form, and for your interest in helping Richmond prepare for an emergency.

As classes are scheduled we will send you information about them. The messages will come either from the office of Emergency Services staff at richmondprepares@ci.richmond.ca.us or from authorized REACT/CERT volunteers at richmondprepares@yahoo.com.