Adventure Pursuits and Rock Gym Staff Application

1. First Name

2. Last Name

3. Please choose any of the following that apply to you:

4. Date of Birth (MM-DD-YYYY)

5. Street Address

6. City

7. State

8. Zip Code

9. Cell Phone

10. Email Address

11. Positions Applying For:

12. Employment Background (Include employer, position, dates, contact person, phone and if we may contact)

13. Trainings or Certifications (Include First Aid, CPR or other medical certifications and expiration dates)

14. Describe ropes course facilitation experience, rock gym or climbing experience and camping experience. Include duration, location and activities. Do not feel unqualified if you do not have these experiences.

15. What are the main reasons you are applying for this role with La Vida?

16. What are three gifts, talents and special abilities you would bring to the La Vida staff?

17. What has been your past experience with La Vida? What did you learn from that experience? Who were your facilitators, counselors, or trip leaders?

18. What leadership training, positions or experiences have you had that would be beneficial in working with La Vida? How do you want to grow as a leader/facilitator?

19. What is one lesson you would want a participant to leave with after an event with you?

20. Are you working any other jobs or do you have any other obligations that might conflict with the position you are applying for?

21. Reference 1: Name, Address, Phone Number and Relationship

22. Reference 2: Name, Address, Phone Number and Relationship

23. Reference 3: Name, Address, Phone Number and Relationship

24. The information I have provided is true and accurate.