SEARCH AND RESCUE - INTEREST FORM

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SEARCH AND RESCUE - INTEREST FORM MINIMUM REQUIREMENTS: Be at least age 21 years old Be a citizen of the United States Be a resident of Salt Lake County Have a valid Utah driver's license Have a high school diploma or GED Have a current medical certification (or currently enrolled) in emergency medical care by a nationally recognized organization that includes at least 50 hours of classroom training (e.g., First Responder) Pass a Salt Lake County physical exam Not have been convicted of a crime punishable by imprisonment in a federal or state penitentiary or of an offense involving dishonesty, unlawful sexual conduct, or physical violence. Not used marijuana in the past two years Not unlawfully used, sold or possessed a controlled substance in the past five years Not have been convicted of a D.U.I. within the previous two years beginning with the date of conviction to the date of application. Name: Address: City: State: Zip Code: Home phone: Mobile-Phone Work phone: Email Current occupation Education: High School Some College AS (2 yrs) BA (4 yrs) Other From what source did you learn of the Sheriff's Search and Rescue Team? Why do you want to become a member of the Search and Rescue team? What previous experience, if any, have you had in Search and Rescue?

Are you presently a student? Yes No Where? Schedule : Current Employer s Name: How Long? Address: Phone: Schedule: Previous work experience How Long? Medical First Responder Skills ( 50 Hour course minimum requirement) What type of first aid or medical training do you have? Certification Number If currently enrolled, course & date: Describe any experience you have had providing emergency medical care? Mountaineering skills High angle scrambling Rock Climbing Hiking and Mountain biking Navigation- map/compass/gps Camping/hunting Ice climbing

Winter skills Resort skiing and snowboarding Backcountry skiing and snowboarding Snow shoeing Avalanche awareness Water Skills Rafting/canoeing/ Kayaking Swiftwater Experience Swift water rescue Swimming/life-guarding Scuba diving Motorized equipment Describe your abilities with the following types of equipment: ATV Snowmobile Powerboat Wave-runner

Physical Fitness Salt Lake County Sheriff s Search and Rescue requires its team members to complete an annual physical fitness test. This consists of a 1.5 mile with an altitude gain of 1800 feet, carrying a 20 pound pack. This is a timed event and must be completed in 50 minutes. The location is the Tolcat trail on Mt Olympus. The distance is from the trailhead to the stream crossing. Are you capable of meeting this requirement? Yes No Describe what you do to stay in shape. How Often? Availability Probationary members are required to maintain 66% attendance at all Meetings, Trainings and Callouts (approximately 100 events per year). After probation, this requirement drops to 50%. Callouts can be day or night, at a moments notice, 24 hours a day, 7 days a week. Will your schedule allow this commitment to the Team? Members of the Salt Lake County Sheriff s Volunteer Search & Rescue Team are asked to make a significant sacrifice of their personal time away from family and work. In addition, members have historically spent up to $500.00 during their first two years on the Team to obtain proper equipment and clothing (The exact amount will depend on what gear you already own). I certify that I meet the minimum requirements and that information contained in this form is truthful. If appointed, I understand I must be a residence of Salt Lake County, and that I must pass a criminal background check and a Salt Lake County Sheriff s Office background check. Signature Date Return this interest form to Special Operations, 3510 South 700 West, South SLC, Utah 84119

For more information about Salt Lake County Sheriff s Search & Rescue please call 743-5654. Please include with your application: A copy of your current medical certification Copy of your valid Utah Driver s License Any documentation relating to applicable Search & Rescue skills