NSP CERTIFIED PROGRAM APPLICATION - Page 2
List OEC, ski and toboggan, and other patrol-related activities during the last three years.
To the best of my knowledge, the information on this application is accurate.
Applicant Signature_________________________________________________ Date______________
To the best of my knowledge, this patroller is currently and NSP member in good standing. I have been directly or indirectly his/her supervisor for ______ years. During that time he/she has exhibited an attitude, work ethic, skill level, and dedication to patrolling at the highest level. I recommend this individual as a certified candidate.
Supervisor Signature________________________________________________ Date______________
| List OEC, ski and toboggan, and other patrol-related activities during the last three years. |
Date Application Received__________________________________
| MODULE | DATE COMPLETED |
| Area Operations and Risk Management | |
| Avalanche Management | |
| Emergency Care | |
| Rope Rescue and Lift Evacuation | |
| Skiing | |
| Toboggan Handling |
Date Program Completed___________________________________________________________
Division Certified Coordinator_______________________________________________________
Certified Number Issued_____________________________ Date___________________________