Application Form

SIS40313 Certificate IV in Outdoor Recreation

Please send your completed application form and any enquiries to:

Address / Outward Bound,
Learning & Development
Naas Road
Tharwa ACT 2620
Contact Details / Phone / +61 2 6235 5700
Fax / +61 2 6237 5224
Email /
Website /
  1. Personal Details

Full Name (First, middle and surname)
Are you over 18 years of age?
Nationality
Do you hold a visa? / Y / N / Visa Class
Current Address
Post Code
Contact Details / Home / Work
Mobile / Skype
Address
Email
  1. Education

School Name / Years Attended / Degree/Major/Certificate Obtained
  1. Qualifications

Do you have the following qualifications (please attach evidence) / YES / NO / Expiry Date (dd/mm/yy)
CPR Certificate / YES / NO
Wilderness First Aid (60+ hours) / YES / NO
Bronze Medallion / Water life Saving Certificate / YES / NO
River / Swift Water Technician / YES / NO
Certificate IV in Outdoor Recreation or Equivalent / YES / NO
Other

Please attach additional sheets if needed

  1. Personal Experiences

Please answer the following questions to provide us with a better opportunity to understand your leadership experience and self-assessment skills.

a) Please describe why you are interested in studying the Certificate IV in Outdoor Recreation at Outward Bound Australia?

b) Please describe briefly, any previous outdoor experience and experience leading groups you may have.

c) Please describe an instance where you were put in a challenging position and how you over came this challenge.

d) What is your approach when managing conflict with peers or other co-workers?

e) Please describe what it means to be an excellent leader, and a time when you felt that you exuded those qualities.

  1. References

Note: Email addresses are essential for international references

Name
Organisation / Position
Address
Contact Details / Phone
Mobile
Email address
Name
Organisation / Position
Address
Contact Details / Phone
Mobile
Email address
  1. Medical History

Do you have any medical conditions or previous injuries that may inhibit your ability to lead an Outward Bound course?
If so please explain
  1. Declaration

I declare the above information to be correct and authorise Outward Bound Australia to consult my referees to request verifications and/or academic transcripts from the individuals or institutions herein. I understand that it is necessary for me to undergo a medical examination and Working with Vulnerable people check prior to commencement of the course.
Signed / Date

Outward Bound Australia would like to keep your application on file. In the event that your current application is not successful we may contact you in the future with other opportunities.

 Please tick this box if you DO NOT agree to us keeping your application on file.

Application Checklist

Please make sure you have completed and enclosed all the required documentation listed below.

 Completed Application

 CV/Resume

 Evidence of qualification (attached)

Pending a successful interview you will be required to provide:

 A current Working with Vulnerable People (ACT)

 Copy of your current drivers licence

Application Form v1.5Outward Bound Australia Page 1 of 4