Office of Emergency Management

11 Water Street · Brooklyn, NY 11201

New York City Community Emergency Response Team

Community Board Application Form – Winter 2006

To help neighborhoods better prepare for future emergencies, the Office of Emergency Management is expanding the New York City Community Emergency Response Team (CERT) Training Program. Our goal is to have at least one CERT Team in every Community Board by the end of 2006. We currently have the funding to train ten new teams. In coordination with the Borough Presidents offices, we are accepting applications from Community Boards wishing to recruit community groups to participate in training during the following time period:

Cycle 6: February – April 2006

Community Board Responsibilities

The CERT fact sheet outlines the CERT program and responsibilities of Community Boards wishing to support CERT training.

Application Submission and Deadline

Applications must be received by January 26th, 2006, and may be submitted by mail or e-mail to:

Mailing Address:

Sharon Hawa

CERT Program Manager

New York City Office of Emergency Management

11 Water Street, Brooklyn, NY 11201

E-mail:

To receive an electronic version of this application, send an e-mail to

Questions? Call Sharon Hawa at (718) 422-4865

Selection Process:

Applications will be reviewed by representatives of NYC CERT partners including: OEM, FDNY, NYPD, Citizens for NYC, The American Red Cross in Greater New York, and Borough Presidents’ offices. Applications will be scored based on responses given to each question. If there are several top candidates with similar scores, preference for this round of training will be given to Community Boards not adjacent to existing CERT teams.

Community Boards will be notified of results by February 3rd.

Contact Information

Community Board (number and borough): ______

Areas covering: ______

______

Contact Person (Mr., Mrs., Ms., Miss):______

Title:______

Address______

Work Phone ( ) E-Mail: Cell Phone ( ) _

Application Questions

Please feel free to attach a separate sheet with answers to the following questions:

1. Demonstrate strong interest for CERT in your Community Board.

Examples: Inquiries from groups/individuals interested in CERT, disaster preparedness events held in your community, other related events sponsored by your Community Board.

2.  Demonstrate your Community Board’s ability to support a CERT team.

a.  Access to appropriate facility in which to conduct training (see fact sheet for details)

b.  General Strength of Community Board

Examples: Specific success(es) of past projects, support from the community, infrastructure, leadership

3.  Demonstrate ability to recruit individuals from a wide range of groups

(associations/organizations, etc.)

Examples: detail relationships with specific organizations, past collaborations.

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I have carefully read the NYC CERT Community Board Application and Fact Sheet. If my Community Board is chosen, we will comply with guidelines set forth in both documents.

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Representative Name Representative Signature Date