When

Saturday, November 6, 2021 at 5:50 AM EDT
-to-
Saturday, December 31, 2022 at 6:50 AM EST

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Where

www.zoom.us

KY 41042

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Contact

Melissa Adamchik, Executive Director, Tristate Trauma Network
Tristate Trauma Network
859-866-4238
madamchik@tristatetraumanetwork.org

Community Resilience Certification (Columbus CARE project)

This form is for completers of the Level 1 and Level 2 Community Resilience Certifications Series being hosted by the Columbus CAR E Coalition.

* Required information

Personal Information

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  • Fee

    Type Fee
    $25.00
    $50.00

Business Information

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  • Your application requires that you also: Have sent documentation of completion of required course work/trainings & consultation (this can be sent by trainers if they kept a list of attendance, but it is ultimately YOUR responsibility to secure this, not the certifying body's responsibility). Have received a passing score on the competency test (will be verified by instructors). Note: Applications received during the month will be reviewed during the last week of the month. Please allow up to 30 days to receive your certificate in the regular mail. If you don't receive within 30 days, please email madamchik@tristatetraumanetwork.org.

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    Do you certify that the information is complete and, to the best of your knowledge, factual and correct?

$9,999.99

Payment

Payment Method

  • Please make check payable to:
    Tristate Trauma Network
    P. O. Box 6331
    Florence, KY 41042

Payment Summary


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