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1125 Colonel By Drive
Ottawa, ON K1S 5B6
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First Aid Kit Request Form
The Unified Support Centre (USC) lends one or more of a variety of first aid kits to the Carleton community for up to 30 days at a time.
The USC requires a $10 or $20 deposit depending on the borrowed kit, made via e-transfer, cash, or credit card. The deposit is returned as long as the kit is brought back on or before the agreed upon date of return - the USC does not charge for used supplies!
Students wishing to borrow a kit for more than one month at a time must return their original kit and sign out another kit every 30 days.
Contact Information
First Name
*
Last Name
*
Student Number
*
Please bring your student card when retrieving your kit. The USC's Borrow a First Aid Kit service is only available to Carleton University students.
Preferred Email
*
Phone Number
*
Kit Selection
The Unified Support Centre's Borrow a First Aid Kit service offers six (6) kit options. View the kit's inventory list here!
Please select your preferred kit type.
*
If you would like to borrow multiple kit types, select your first kit type now. Indicate "yes" when prompted to return to the kit selection menu and select additional kit types.
Small
Compact
Daypack
Standard
Car
Survival
Please select your preferred Small kit.
*
A belt kit is the smallest option and attaches to a wearer's belt. A fanny pack kit attaches around a wearer's waist and contains two additional empty pockets.
Belt
Fanny Pack
Please select your preferred quantity of Small - Belt kits:
*
Requires $10 deposit each. Maximum inventory of 6.
1
2
3
4
5
6
Please select your preferred quantity of Small - Fanny Pack kits:
*
Requires $10 deposit each. Maximum inventory of 4.
1
2
3
4
Please select your preferred quantity of Compact kits:
*
Requires $20 deposit each. Maximum inventory of 3.
1
2
3
Please select your preferred quantity of Daypack kits:
*
Requires $20 deposit each. Maximum inventory of 3.
1
2
3
Please select your preferred quantity of Standard kits:
*
Requires $20 deposit each. Maximum inventory of 4.
1
2
3
4
Please select your preferred quantity of Car kits:
*
Requires $20 deposit each. Maximum inventory of 3.
1
2
3
Would you like to request a supplementary Winter/Offroad add-on?
*
Each Winter/Offroad add-on contains two traction mats, a small shovel/pick, and a blanket.
Yes
No
Please select your preferred quantity of Survival Backpack kits:
*
Requires $20 deposit each. Maximum inventory of 2.
1
2
Scheduling a Pick-Up
Form Completion Warning
*
I acknowledge that this Borrow a First Aid Kit Request Form is not submitted until I have completed the disclaimer questions after scheduling my pick-up.
I acknowledge that filling out this form does not indicate that I will receive all kits requested as it is based on the USC's inventory.
I Understand
Please schedule a pick-up time and date.
*
Please note that receiving a Calendly email confirmation does not indicate that this form has been successfully submitted.
YYYY dash MM dash DD
Pickup time
*
Select a Pickup Time
16:00
16:15
16:30
16:45
17:00
17:15
17:30
17:45
18:00
18:15
18:30
18:45
19:00
19:15
19:30
19:45
20:00
20:15
20:30
20:45
21:00
21:15
21:30
21:45
22:00
22:15
22:30
22:45
23:00
23:15
23:30
23:45
How would you like to provide your deposit when retrieving your kit?
*
E-Transfer
Cash
Credit Card
I agree to complete the Borrow a First Aid Kit Sign Out Contract upon arriving at the USC office to retrieve the kit.
*
I accept
I agree to bring my student card to verify my identity upon arriving at the USC office to retrieve the kit
*
I accept
I agree to return the first aid kit within thirty (30) days of borrowing the kit(s). I understand that I will forfeit my deposit if I return the kit after the agreed-upon return date.
*
I accept
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