EMT Squad Application

This form is for those interested in joining the SJU EMT Squad. To complete this form you must either be currently enrolled in an EMT course or already hold your EMT certification from the NREMT.

If you have any questions feel free to reach out to [email protected]

Name

	First:
	Middle Initial:
	Last:
	Banner ID #;		if new student enter n/a

Birth Date

E-Mail

Phone Number

(320)XXX-XXXX

What is the best way to contact you?

	CSB/SJU Email
	Text Message
	Phone Call

Home Address

Address, City, State, Zip Code

Which of these best describes you.

	Student enrolled at SJU
	Student enrolled at CSB
	Staff member at SJU
	Other

Where do you plan to live for the next academic year?

	On Campus @ SJU
	On Campus @ CSB
	Off Campus

Major/Minor (if enrolled student)

	Major
	Minor
	Anticipated Graduation Year

Do you intend to study abroad in the future?

this will not impact your ability to join the squad

	No
	Yes, when?

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