Service Trip Questionaire Form

Your Name:________________________

Trip Number:______ Trip Name: ___________________

1. Give a description of your wilderness backpacking experience. Consider mentioning any Sierra Club trips you've been on, as well as private or family trips. Include dates, length of trips, and degree of difficulty. Be sure to mention the most difficult outing (or types of outings) that you have done. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

2. What do you so now, on a regular basis, to keep in shape? Do you get to high elevations? How often? _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

3. Do you have any strong food preferences, allergies, dislikes, or special dietary needs? (If you have any favorite wilderness recipes, please include them on a separate sheet.) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

4. Please describe any medical training you have -- CPR, first aid, EMT, nursing, etc., including dates, and if your certification is current. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

5. What do you expect to contribute to this trip? _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

6. What do you expect to get out of this trip? _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Please send this completed questionaire directly to the trip leader.
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