LEU - Longmont Emergency Unit

Volunteer Application

Apprentices, General Rescuers and Reserve Members who choose to support medically, are required at minimum to be have First Responder Certification. These members are expected to make themselves available to work weekend duty when assigned. Members who desire to perform dive rescue must be certifiable sport divers and have their own equipment. Our dive team is trained in underwater search, rescue and recovery as well as ice and swift water rescue. Underwater communication and dry suits are supplied.

Last: First: MI:

Home Address:

City: Zip:

Home Phone:

Date of Birth: Sex:

Place of Employment:

Work Phone:

Work Address:

E-mail:

Have you ever been convicted of any violation (regulation, ordinance or law) by any law enforcement agency (local, federal or military) ?

If yes, specify dates, locations, reasons and details (include name of probation or parole officers). List all violations except those involving fines of $25.00 or less:

Do you have any physical conditions which would limit your activity in rescue operations?

If yes, explain:

Do you have a valid First Responder first aid card or equivalent?

Do you have a valid CPR card?

Please list any special training that might be valuable to rescue work?

Are you willing to partake in any training programs, special courses, etc., necessary to meet LEU requirements?

Have you ever driven a large truck or bus?

Have you ever driven an emergency vehicle?

Are you willing to assist local Law Enforcement personnel, State Patrol and local Fire Departments?

Do you understand that at times you will be under Civil Authority?

Please select which you are most interested in:

By filling out this form we can get to know you and contact you about joining the unit. The questions asked on this form are the actual questions that are on the official application. Because a signature is required and an additional form is required to release your driving and criminal history to us you will need to fill out the actual paper forms. This would best be done at one of our weekly meetings.

Additional questions about joining the unit can answered by E-mail, click here.