TNF - ACC SUMMER Leadership Course Application Form

The Alpine Club of Canada

The North Face Summer Leadership Course Application Form
To complete your application to the ACC/TNF Leadership Course please complete the following:

1) Complete this form
2) Email your supporting documents to adventures@alpineclubofcanada.ca
3) Have your section endorsement sent directly to adventures@alpineclubofcanada.ca

The deadline for applications is as follows:

Summer Course: April 27th, 2018

Late applications will not be accepted. Announcements of successful applicants will be made no later than April 27th.  Completion and return of The Alpine Club of Canada's Waiver of Liability form is a condition of registration in our leadership courses. Participants will not be allowed to attend the course if the completed waiver form is not received prior to the commencement of camp. You can download the form from our web site at www.AlpineClubofCanada.ca.

* denotes mandatory fields

This is the only form which can be used when applying for The North Face Leadership Course. If your application is not fully completed it will be returned for completion to ensure our volunteer committee can properly assess all applications. Once you begin filling out this form your data will be saved at this url for ONE WEEK. Bookmark this page and return to it anytime within ONE WEEK to complete the form.

Please note the Selection Committee strongly prefers receiving applications in electronic format.
General Information
Training Applied for: *

The North Face - ACC Summer Leadership Course
Personal Details
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Birth Date *

Month Day Year
E-mail *
Phone Number *

Area Code Phone Number
What phone number can we reach you on the day of the trip in case of last minute changes?

Area Code Phone Number
ACC Membership Number (if known)
Section Affiliation
How many years have you been a member of your current section?
In past years, TNF has graciously donated clothes to participants that attend these leadership courses. These donations are not guaranteed but appreciated as it goes above and beyond the commitment TNF has with the Alpine Club of Canada. Answering the two questions below regarding sizes is a way in which to expedite the process of helping TNF decide if they are able to contribute through a donation. In no way is this a guarantee that TNF will donate to participants. Only choosen applicants are eligible for these donations. Please note that there are no exchanges or returns on these items if they don't fit.
Jacket Size

X-Small - Women only Small Medium Large X-Large
Pants Size

X-Small - Women Only Small Medium Large X-Large
Emergency Contact Information

Please select someone who is not accompanying you on this trip. Note that we will also contact this person if we are unable to get in touch with you about last minute information related to your trip.
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Relationship
Phone Number *

Area Code Phone Number
References

Please have your Section Executive email us their endorsement of your application. In addition, have two of your skiing or climbing partners, one being an ACMG mountain guide who works on ACC camps, a current ACC camp manager or amateur leader email us a letter of reference for you. They should email the letter to the ACC directly (adventures@alpineclubofcanada.ca) and NOT via you. List the references (2 total) that will be forthcoming (include name, relationship, email address):
Who will provide your Section Endorsement (name and position)?
Reference 1:
Reference 2:
Your Experience

This section will be used to assess your skills and overall suitability for this course.
How many years have you been Sport Climbing?
How many years have you been Trad Rock Climbing?
How many years have you been Mountaineering?
How many days have you been out on your longest climbing/mountaineering trip?
List all relevant outdoor skills courses you have taken (i.e. avalance, first aid etc.), including date, course name, location and provider.
ESSAY 1:Outline your three most difficult mountain trips, including mountaineering objectives, scrambles, rock routes, ice climbs, ski mountaineering trips. State the date completed. Include the route taken on the various objectives. Please note if the trips were done with a professional guide, with friends, or whether you organized/led the group or were a trip participant. (500 words or less)
General Club Background
ESSAY 2: Describe why you want to attend the ACC TNF Leadership course. (500 words or less)
ESSAY 3: Describ in detail (with specifics) how you plan to contribute to your Section in the next two to three years. (500 words or less)
Have you served as a volunteer for your section in any capacity during the past one to two years? If so, what were you involved in?
How many non-outdoor Section activities have you attended in the last two years? (ex. slide shows, pub nights)
How many Section climbing activities have you attended in the last two years ?
Discuss how you intend to display maturity, the ability to work in a group setting and a willingness to learn during the TNF course.
Feel free to discuss anything else that you feel will make you a good candidate for leadership training at this level.
Health and Fitness

All health information is considered personal and provate and is held by the ACC in the strictest confidence.
Current state of health *
Height *
Weight *
Date of last Medical *

Month Day Year
Status at time of last Medical *
Have you had any serious illnesses or conditions in the past five years? If so, please explain: *
Medications taken on a regular basis, and what the medications are for: *
Do you have any allergies that we should know about? *
How would you rate your current fitness level? *
Please outline your current and planned regular physical activity schedule. *
Food Preferences
Do you have any food allergies (please specify in detail), sensitivities or preferences (i.e. vegetarian)? *
Skills & Training

Please rate your competence in the following skills. Not being competent with a skill does not necessarily mean you will not be accepted. Only a basic level of competence is required. High technical skill levels are NOT mandatory and a history of leading on waterfall ice or alpine terrain / mountaineering is not required. In rating yourself please use the following scale: 0 – never done it before 1 – have done a few times, but not yet competent 2 – have done it a number of times, basic level of competence 3 – competent 4 – very competent, could teach it to others 5 – professional skill level (i.e. ACMG apprentice or guide; experienced CSIA level 2 or higher ski instructor)
Rock Climbing
Climbing Knots
Movement Skills - Rock Climbing
Movement Skills - Ice Climbing
Rappel Skills
Belyaing skills for belaying a leader and a second using a belay devide AND Munter Hitch
Knowledge Regarding Use of Protection
Construction of Simple Belay Anchors
Basic Belay Tie-off and escape
Able to swap leads on rock in the 5.3 - 5.5 range
What grade of outdoor sport rock climbs can you comfortably lead (without hanging on the rope)?
How many multi-pitch rock climbs have you completed?
What grade of outdoor trad rock climbs can you comfortably lead?
List any rock climbing instruction you have taken recently. Include agency / instructor, course taken and date.
Discuss anything else that you feel the selection committee should know about your rock climbing experience
Snow & Ice / Alpine Climbing
Basic movement skills on snow and ice (step-kicking, self belay and self arrest, crampon use)
Knowledge of snow anchors and belaying on snow
Knowledge of ice anchors and belaying on ice
Roped Travel on Glaciers
Basic Crevasse Rescue
Number of peak climbs involving glacier travel for which you have been in a formal leadership role?
How many mountain peaks have you led that involved glacier travel?
Have you been taught short roping and if so, where ?
Discuss anything else that you feel the selection committee should know about your rock climbing experience
General Outdoor Mountain Travel Experience
What is your level of understanding of topographic maps and use of a compass ?
How many moderate scrambles or difficult scrambles have you completed to summits of peaks?
List any currently valid urban or wilderness first aid certification you hold. Include agency / instructor, course taken, number of hours / days and date completed.
Please provide any further comments, special requests, or interests that you have by emailing adventures@alpineclubofcanada.ca. Thank you for taking the time to fill out this application!
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The Alpine Club of Canada

General Information

Personal Details

Emergency Contact Information

References

Your Experience

General Club Background

Health and Fitness

Food Preferences

Skills & Training

Rock Climbing

Snow & Ice / Alpine Climbing

General Outdoor Mountain Travel Experience