2024-2025 CUSERT New Responder Application
Thank you for your interest in joining CUSERT. Before filling out this form, be sure you have read the requirements for CUSERT members. The deadline for applications is September 14, 2024, but we encourage you to submit your application as soon as possible. If you have any questions or concerns, please contact us at applications@cusert.com. This application is designed to use personal responses to assess one’s candidacy for CUSERT. As such, the use of generative AI tools will disqualify your application.
Personal Information
Name
*
First Name
Last Name
Preferred name (if different from above)
eg. nickname
Pronouns
Date of Birth
*
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Month
-
Day
Year
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Email
*
Please enter your official Carleton email address (example@cmail.carleton.ca)
Phone Number
*
-
Area Code
Phone Number
Local Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Permanent Address (if different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Student Number
*
Faculty
*
If you are unsure, please consult the list here: www.carleton.ca/academics/departments
Program
*
Year in Program (as of September 2024)
*
Expected Total Number of Years in Program
*
For example, if you are in a four-year program but you plan on taking five years to complete it, your answer to this question would be five.
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First Aid Certification
All applicants must have valid Standard First Aid / CPR Level C certification, or have plans to complete a course before September 15, 2024.
Please select one of the following
*
I will be uploading my certification.
I will be taking a course to obtain my Standard First Aid and CPR Level C certification before September 15, 2024. I understand that my application will no longer be considered if I do not submit my certification to applications@cusert.com by September 15, 2024.
Standard First Aid / CPR C Certification
*
Upload a File
Please upload a scanned or digital copy or image of your certification
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Applicant Questions
Why do you want to join CUSERT?
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Describe any relevant skills, qualities or experiences you have that would make you a good first responder.
*
Tell us about a time you solved a stressful problem and what you learned from this experience.
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At CUSERT we believe strongly in constantly improving and setting goals. What would be your biggest challenge in an emergency situation that you would need to overcome to provide the best possible care?
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Miscellaneous
Have you applied to CUSERT before?
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Yes
No
How did you hear about CUSERT?
*
eg. social media post, friend, Carleton website
Do you know any current or former CUSERT responders?
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Yes
No
Please provide the names of current or former CUSERT responders that you know.
All applicants must be in Ottawa for the Fall 2024 and Winter 2025 semesters in order to carry out their duties as a CUSERT responder if selected.
*
I will be in Ottawa for the Fall 2024 and Winter 2025 semesters.
Some CUSERT recruitment activities will take place online. Successful applicants will need a computer and reliable internet access to complete interviews and the online assessment. Should you have concerns about this, CUSERT will make alternate arrangements.
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I will have a computer and reliable internet access.
I have concerns about my access to a computer and reliable internet access.
All applicants who are invited to the interview and written assessment stage must provide the contact information for a minimum of two professional/academic references.
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I will be able to provide the contact information of two suitable references.
All applicants who are successful after their interview and written assessment must attend our Initial Training Weekend, which will take place September 21-22, 2024.
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I will be available to attend Initial Training Weekend from September 21-22, 2024.
By clicking "I agree" below, I hereby grant the CUSERT Executive and Campus Safety Services to access my personal information for use by the CUSERT Executive and Campus Safety Services to be used for background checks and other purposes as deemed necessary.
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I agree
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