CERT Information Request

To request information, complete the form below. You must be 18 years of age or older and live and/or work in Arlington County to join.

Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email
Civic Association
Find your Civic Association (opens in a new window)
Please be aware that information submitted through an Arlington County Government website is considered to be a Public Record under the Virginia Public Records Act and may be subject to release by the County in response to a request made under the Virginia Freedom of Information Act.
Arlington County may withhold your name and contact information in accordance with the Virginia Freedom of Information Act. Please indicate, by checking the box below, if you would like for the County to seek to keep this information confidential.
Do Not Disclose Opt-Out
- Please do not disclose my name and contact information in response to a request under the Virginia Freedom of Information Act. I recognize that the County cannot guarantee the confidentiality of my name and contact information but ask that it do so to the extent permitted by law.
Phone
This field is for validation purposes and should be left unchanged.