Cadet Application

Name

Phone

Address

E mail Address

example@example.com

Date of Birth

Date

School attending

Do you have your parents'/ guardians' permission to apply to this fire service program?

YESNO

Name of parent/guardian

Parent/Guardian Address

Parent/Guardian Home phone

Parent/Guardian Cell Phone

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Home Phone

Emergency Contact Cell Phone

Emergency Contact #2 Name

Emergency Contact #2 Relationship

Emergency Contact #2 Home Phone

Emergency Contact #2 Cell Phone

BACKGROUND INFORMATION

(A background check will be done. Those convicted of felonies are prohibited from joining)

Have you ever been arrested or ticketed? (Felonies, Misdemeanors, Traffic Violations, Ect.)*

YESNO

If yes, List the dates and charges:

PERSONAL INFORMATION

(Use another sheet of paper if needed)

1.) What interests you most about becoming a member of our youth fire service program?

2.) What do you expect to obtain from joining our youth fire service program?

3.) What special training or insight can you bring to the youth fire service program?

4.) Please list other activities, in detail, that you are involved in (sports, church, school, volunteer work, etc..)

Applicant signature and date

Parent/guardian signature and date

Personal Consent Form

My Son/Daughter, blanks, has my permission to join the youth program for this Fire Department. I, blank give my consent to allow him/her to be part of the program and do not hold the department , it's members, or the Township responsible for any injuries or actions that occur under reasonable circumstances as part of the program.

Applicant signature and date

Parent/guardian signature and date

CONTRACT OF UNDERSTANDING

My son/daughter and I have read all the guidelines, protocols and rules regarding the department's youth program and understand that youth program members will serve in support roles for the department as they learn and train for possible future service. My son/daughter and I understand that members of the youth program are to follow instructions from superiors and follow department and program safety protocols at all times. We also understand that he/she will represent the department and act in a professional manner that is courteous and respectful at all times. We understand that there is a "zero tolerance policy" regarding the use of alcohol and drugs while participating in this youth program. My son/daughter and I understand by signing below gives the fire department consent to include my son/daughter in the random drug screening policy used for the department. My son/daughter and I also understand that in signing this Contract of Understanding, we are declaring that any violation of the program's/department's standard operating procedures/guidelines will be dealt with by the program's leaders and/or department officers and may be grounds for immediate dismissal. Any acts that violate state or federal laws will be referred to the proper law enforcement agency.

Applicant signature and date

Parent/guardian signature and date

ALL CADET FIREFIGHTERS MUST:

1. Be enrolled in school or otherwise have graduated high school

2. Must maintain a minimum grade point average in school ('C')

3. Be equipped with proper personal protective equipment appropriate to the activity being performed

4. Be mobilized as a unit, not as individual on-call firefighters. If you show up on-scene in a personal vehicle, you are present as a citizen and are not allowed to participate

5. Wear seatbelts at all times when in personal vehicles or departmental apparatus

6. Attend all meetings and trainings

7. Conform to and abide by all program rules

All Cadet firefighters are prohibited from:

1. Driving any vehicle, personal or departmental, in "emergency mode"

2. Performing fire suppression inside structures, on vehicles or in wildland fires

3. Entering a confined space as defined by Federal Regulations

4. Responding to incidents that potentially contain hazardous materials

5. Using power tools on scene

6. Operating a personal vehicle with aftermarket "emergency" lights

7. Perform ice rescue operations

8. Performing an activity that involves the risk of falling 6 feet or more

9. Substituting for trained firefighters Responding to incidents while school is in session

Cadets that are 15 years of age:

1. Participate in nonemergency events between 7am and 10pm

2. Receive training and instruction that does not involve fire, smoke, toxic gas or hazardous materials

3. Wear protective equipment that readily identifies them as youths

Cadets who are 16 and older may do what 15-year-olds may do, plus:

1. Respond to emergency incidents as observers with proper supervision

2. Respond to emergency incidents, if signed up for shift stay

3. Take part in more advanced training

4. Respond to emergency incidents on departmental vehicles

5. Participate in search and rescue operations away from structural fires

6. Enter a structure after the fire. is out and it is declared safe by the incident commander

7. Pick up hoses and clean fire equipment after the incident commander declares area safe

8. Participate in rehab operations

9. Use power tools during training

10. Operate pumps at the fire scene, after appropriate training

11. Handle charged hose lines up to 1 3/4 inch in diameter

Level 1 (15 years old): Basic Tasks

Apparatus and equipment familiarization
Fire Operations Awareness
Fire extinguisher operations
First Aid/ CPR
Rehab Training/ Vital signs
SCBA operations (care and maintenance)
HIPAA laws
Blood-borne Pathogens
Incident command basics

Level 2 (16-18 years old): Advanced Tasks

Ladder and Hose operations
Advanced First Aid
Hazmat awareness and operations training
Fire Operations and behavior
SCBA donning and doffing
Incident Command- advanced and NIMMS
Fire Prevention and Inspections
Pump Operations

Ride-along Activities

After successful completion of Level 2, the Cadet should be eligible to participate in ride-along activities. The program should develop written guidelines regarding cadet member participation on ride-along activities, to include:

Purpose of the ride along
Authorization to ride
Rules and hours of duty
Mandatory Seatbelt use
Participation at emergencies
Station activities
Insurance release
An evaluation/checklist that documents the activities performed

OATH

PLEDGE TO MY PEERS

We are colleagues with a common mission. I pledge to meet my commitment to you as a team member of this department and expect you will meet your commitment to me. I will practice and model the Key Principles listed below in my relationship with you and all other department members:

Maintain and enhance self-esteem

Listen and respond with empathy Ask for help in solving the problem I accept my individual and our collective responsibility to solve the problem; It is not important to assign blame. I accept that all decisions are not perfect, and if I disagree, I will do so openly and present possible alternatives to an ultimate decision in a group or a one-on-one situation. Once a decision is made I will try to make it work. If I disagree or find that a decision is not workable, I will work through the appropriate decision makers and/or decision-making channels to have it

I will ensure, as a leader of a decision-making group, that appropriate communication during the Decision-making process and about the final decision is given to all affected parties, and I will Also communicate the "why" behind such decisions.

I will accept you as you are today. I will talk to you promptly if I have a problem With your decisions, behavior or actions, and I will not talk to others, including; members Of the cadet program, leaders of the program or members of the department, about a problem Without talking to you first.

I will remind you not to "attack" another team member; if I hear you doing so, I will ask you To talk to that person.

I will ask you for feedback about my behavior and respond openly to your request for feedback.

I will seek opportunities to compliment you for contributions you have made. I will hold other members of the team accountable for fulfilling the above agreements, Remembering first my commitment to you and others within our department.

Cadet Signature

Date