AR Application

Please read through this application before you begin filling out out. Make sure that you are ready to answer all the questions, and that you have your climbing resume prepared and ready to attach before you begin. You will not be able to save your answers if you only get part way through the application.

Please use proper capitalization and punctuation.

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Evening Phone Number

* Daytime Phone Number

* Email Address

Receive Mass Email?

You must check this box so we can communicate with you about AR via email.

* Mazama Member?

Yes

* Age (18 yr. min)

* Occupation (optional)

* What do you expect to learn or gain from the Advanced Rock Program?

* What is it about leading 5th class rock that appeals to you?

* Describe your formal climbing education (most recent first).

* Though doubts and uncertainties are normal, do you feel prepared, mentally and emotionally, to take on the challenges of leading? Explain. Please be candid?

* Please list names and phone numbers of two people with whom you've climbed.

* Do you have any current medical or physical conditions of which the leaders should be aware?

* Have you applied for the Advanced Rock Program previously? What was the outcome? Please be thorough. (Dates, circumstances, etc.)

* Are you applying as part of a group or pair? If so, what are the names of the other(s) with whom you are applying?

* If you are applying with others and one of some of them are not accepted would you still wish to participate?

* Do you train in a climbing gym?

Yes

If yes, how frequently?

* Please attach your climbing resume covering the last 3 years. Include both alpine climbs (snow, rock or ice) and rock routes (sport or trad). Indicated if you led, seconded or other. If you have climbed routes on top-rope indicate the general level and number of routes climbed. Greater specificity is not requested.

Course fees must be paid in full at the first lecture. Application must be submitted by February 15, 2008. You will be required to complete a release from liability waiver before you take the skills test.

* Indicates Response Required