2026 CUSERT New Responder Application

2026-2027 CUSERT New Responder Application

Thank you for your interest in joining CUSERT. Before filling out this form, please ensure you have read the eligibility requirements for CUSERT members on our website. The deadline for applications is September 12, 2026, 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 NameLast Name
Preferred name (if different from above)
eg. nickname
Pronouns
Date of Birth

MonthDayYear
Email
Please enter your official Carleton email address (example@cmail.carleton.ca)
Phone Number

Area CodePhone Number
Local Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Permanent Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Number
CUID
Faculty
If you are unsure, please consult the list here: www.carleton.ca/academics/departments
Program
Year in Program (as of September 2026)
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.
First Aid Certification

All applicants must have valid Standard First Aid / CPR Level C certification, or have plans to complete a course before September 14, 2026.
Please select one of the following
Standard First Aid / CPR C Certification

Upload a File
Please upload a scanned or digital copy or image of your certification Cancelof
Applicant Questions
Why do you want to join CUSERT?
Describe any relevant skills, qualities or experiences you have that would make you a good first responder.
Describe a time when you worked as part of a team to accomplish a goal. What was your role, and what did you learn from the experience?
CUSERT believes 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?

2026-2027 CUSERT New Responder Application

Personal Information

First Aid Certification

Applicant Questions

Miscellaneous