Outdoor Education & Leadership Emphasis Application General InformationName * Required First Last NAU (7-digit) student ID * RequiredNAU email address * Required Current mailing address * Required Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone * RequiredExpected graduation semester: * RequiredFallSpringExpected graduation year: * Required201920202021202220232024202520262027202820292030OEL block prerequisite information Registered as a PRM Major in LOUIE Registered as Outdoor Education & Leadership Emphasis Area in Louie. PRM 331 -Outdoor Leadership Certification I:Semester takenGradePlease choose optionABCDFWIOtherPlease describe here if you have taken a NOLS, Outward Bound, or Wilderness Education Association Course that you would like to substitute for PRM 331. Please include the specific course and the date taken)PRM 216- Wilderness First Responder medical certificationDates takenExpiration date on certification cardCertification provider listed on card:NOLS Wilderness MedicineSOLODMMWMASierra RescueOtherPlease describe here if you have any other higher medical certification- WEMT, EMT, or OEC with expiration date; or a WFR provider not listed abovePersonal philosophy and goalsPlease describe your personal philosophy of Outdoor Leadership: * RequiredPlease describe what you feel the most important lesson(s) you learned during PRM 331: * RequiredFive immediate personal goals for the OEL block:Goal 1 * RequiredGoal 2 * RequiredGoal 3 * RequiredGoal 4 * RequiredGoal 5 * RequiredPlease describe how the OEL Block may influence your long term career goals or ambitions: * RequiredOutdoor experience resumePlease highlight up to 5 of your personal trip experiences in the outdoors. For each, include: Initial Pre-Trip Preparation time/Geographic Location / Area(s); Length of trip; Type(s) of activities (backpacking, biking, boating, climbing, etc.); what you learned.Experience 1 * RequiredExperience 2Experience 3Experience 4Experience 5Work experiencePlease highlight up to 5 (if any) professional work experiences (either paid or as a volunteer) that are relevant to leading others in the Outdoors. For each, include: The organization/company/group; your designated role; Geographic Location / Area(s); Length of trip; Type(s) of activities (backpacking, biking, boating, climbing, etc.); what you learned.Work experience 1 * RequiredWork experience 2Work experience 3Work experience 4Work experience 5EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.