This form is to be completed by Public Safety for Community Emergency Response Team training graduates only.  JCard Administration will print all CERT JCards and notify the requesting Public Safety office when the cards are ready. Public Safety may then collect the CERT JCards from JCard Administration, Clarkston campus, CS building. CERT graduates should not contact JCard Administration directly to request or collect a CERT JCard.

Type of Card: *

New CERT JCard

Replacement CERT JCard

GPC-ID Number: *

First Name: * Person who completed CERT training.

Last Name: *

Campus: *

Alpharetta

Clarkston

Decatur

Dunwoody

Newton

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Additional comments:: *

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