Trip Leader Application

To apply to be a trip leader, please fill out and submit this online form, or print it and submit it to the:

Mountaineering Chair:

Lisa Barboza, lisa.barboza@gd-ais.com, (650) 493-8099

The Mountaineering Chair will contact you.

Name: *

Address: *

City: *

Telephone: *

Sierra Club membership number: *

Sierra Club membership number exp. date: *

Date of OLT 101: *

Date of OLT 201: *

Eighteen years of age or older?: *

PCS Member?: *

Date and type of most recent First Aid Course: *

Applying for leadership on what class of climb?: *

Summarize navigational abilities, climbing skills, and any other information relating to your mountaineering knowledge and exp.: *

List the major peaks you have climbed, including the class of climb, leaders' names, if appropriate, and if you led the climb: *

Additional Comments:

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