ORP Student Trip Leader Form

Personal Information
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First, Last
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mm/dd/yyyy
School Information
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What are you studying?
*Year in School
What is your class ranking?
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Semester/Year Example: Spring/2014
Driver's License Information
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*Have you had a traffic violation or accident in the past three years?
If you answered 'yes' please explain below.
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Certifications
*First Aid Certifications
Click all that apply
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Please list all other certifications in a list. Example: 1. Swift Water Rescue 5/2013-5/2016 2. Wilderness First Aid 6/2012-6/2013
Please upload a copy of your certification.
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Please list activities like this: 1. X 2. X 3. X
*Will you commit to planning and leading a minimum of one outdoor trip per semester?
*Will you commit to approximately 30 hours per month of training, activites and leadership development?
*Are you willing to participate in trips, trainings, and other associated activities on weekends, holidays and school breaks?
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Please type your name and the date below. Example: SIGNATURE, mm/dd/yyyy
Please upload your resume, cover letter and outdoor experience here.
   
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