Outings Training | OLT Workshop Questionnaire

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Logistics Information

First Name:
Last Name:
First name you'd like printed on your nametag:
Email:
City:
State:
Verify your phone number: (xxx-xxx-xxxx)
For which workshop are you registering?	NOTE: If you workshop isn't listed here, your WFA course questionnaire can be found here.
In case of an emergency, please provide us with the following information:	Name:
	Relationship:
	Phone: (xxx-xxx-xxxx)
Special dietary needs: (Vegetarian, vegan, diabetic, food allergies, leave blank if none.)
Will you be attending dinner Friday evening (6-7pm)?	Yes No
Transportation information -- we strongly encourage carpooling. Check one of the following:	Driving on my own Willing to offer rides Need a ride Flying, but getting to the facility on my own Flying and need travel arrangements to the facility
If you selected "Willing to offer rides", how many can you take? If you selected "Need a ride", enter your departure/pick-up city.
T-shirt size:	XL L M S none (These run small. You will get the size you request.)

Outings and Leadership Background

Program Affiliation: (Select all that apply by holding down the Control or Apple keys)
If Local (Group & Chapter) or Inner City Outings, what is the name of your chapter/group/section?
If National, what is the subcommittee you lead for or are interested in leading for? (Select all that apply by holding down the Control or Apple keys)
Do you hold a volunteer leadership position within the Sierra Club in addition to being an outdoor leader?	Yes No
If so, what is the title of your position?
What types of outings do you prefer to lead? (Select all that apply by holding down the Control or Apple keys)
Please list the types of outdoor activities you engage in, both as a leader and a trip participant:
What populations do you prefer to lead for? (Select all that apply by holding down the Control or Apple keys)

First Aid Information

We would like to get a sense of what level of first training leaders have. Please take a moment to look at your certification cards before answering the following questions.

What is your level of First Aid certification? Select one:	None Basic First Aid Advanced First Aid Wilderness First Aid Wilderness First Responder EMT Wilderness EMT Medical Professional
First Aid Expiration date (mm/dd/yr):
Are you CPR certified?	Yes No
CPR expiration date (mm/dd/yr):
If you are a medical professional (or hold other certifications/trainings), please describe:
Have you ever dealt with a "wilderness emergency"?	YesNo
If so, please briefly describe the circumstance and how you handled it.

Workshop Expectations

What are you specifically hoping to gain and/or learn at this workshop?
What are the three most pressing issues regarding outings in your area?
What other outdoor trainings have you previously participated in (in and outside of the Sierra Club)?
For New Leaders only: If you are not currently leading for the Sierra Club, what types of outings are you interested in leading?
For current leaders only: Which other Outing programs (Group & Chapter, Inner City or National) are you interested in leading for or learning about?
On your outings, what is the most frustrating part of leading?
How did you find out about this training event? (Select all that apply by holding down the Control or Apple keys)
Other:

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Sierra Club Outdoor Activity Training Program
85 Second St., 2nd Floor | San Francisco, CA 94105-3459 | Phone: 415-977-5711