Wilderness First Aid Course
Application
 
June 12-14, 2009

Name(s):
Street address:
City and zip code:

Note: You must be at least 14 years old to enroll in the course.

At least one phone number is required:

    Home phone:

    Work phone:


email:
An email address is optional but, if we have it, we will:

 

[  ]  I have a van, large SUV, station wagon, or large truck with a camper shell and I'm willing to haul course gear up to the lodge Thursday afternoon or evening.
I will contact Donna at:
              

[  ] I am willing to help sign students in.
I will contact Donna at:
              

[  ]  I prefer vegetarian meals
(We will do our best but offer no guarantee.)
1
 Confirm receipt of application within 2 weeks and you need not send a self-addressed stamped envelope
2
 Send you updates on the course

[  ]  I am a medical professional or I have completed a wilderness first aid course of 24 hours or more and I would like for Steve to contact me about being a victim during scenarios. (See advantages.)

Sierra Club member number:

Is your submission complete?
Please use the following checklist for a complete application. For example, if you have enrolled in a CPR course, wait until you have the CPR card before submitting your application and deposit.

A printout of this form, completed

A signed check made to WFAC:
$205 for Sierra Club members
$215 for non-members

All course fees are refundable in full until five weeks before the course start date.

A copy of the CPR card for a CPR course completed no more than four years prior to the date of the WFAC
A self-addressed, stamped, legal-size envelope (unless you provided an email address)
NOTE:
WFAC returns incomplete submissions.