Leader Application Form

Section 1 - Personal Details Person name[Required]
Telephone
Email
Street Address
Town or City
Postcode/Zipcode
Country

Section 2 - Application Details What year/s are you interested in Leading for Outlook?

Section 3 - Qualifications Mountain Leader Qualifications Completed
Paddle Sports Coaching Level
Paddle Sports Personal Skills
Lifeguard Qualification
Water Based Qualifications - Other:i.e. water safety, sailing etc.
If Yes: add detail
White Water Rafting Qualifications
If Yes: add detail
Diving Qualifications (PADI, BSAC, Other)
If Yes: add detail
DofE Assessor
DofE Assessor Number
Academic Qualifications
Other Specialist Qualifications
First Aid Certificate held?
Expiry of First Aid Certificate

Section 4 - Experience Overseas Expedition Leader Experience
If Yes: add detail
Expedition Member Experience
If Yes: add detail
Outdoor Youth Instruction Experience
If Yes: add detail
Worldwide Travel Experience
If Yes: add detail
High Altitude Experience
If Yes: add detail
Experience in Hot and Humid Environments i.e. Jungle
If Yes: add detail
Experience in Hot and Dry Environments i.e. Desert.
If Yes: add detail
Experience in Cold / Sub-Zero Environments
If Yes: add detail

Section 5 - References Professional Reference Name
Professional Reference Address
Professional Reference Tel
Professional Reference Email
Personal Reference Name
Personal Reference Address
Personal Reference Tel
Personal Reference Email

Section 6 - Additional Information Employment History - 5 Years
Additional Information: Please provide us with any additional information you feel is relevant to your application.
Right to work in the UK: Do you need a work permit to work in the UK?
Have you spent more than 3 consecutive months working or travelling outside of the UK during the last 5 years?
Do you have a current DBS certificate?
Are you on the DBS update service?

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