Lowland Expedition Leader Registration Traditional course

Lowland Expedition Leader Application form
Course that you are applying for*

Lowland Expedition LeaderLowland Day Walk Leader
Full Name*

First NameLast Name
Personal E-mail*
not school one if possible, we will not pass this on without your permission
Home Address*

House number/name

Street Address

TownCounty

PostcodeCountry
Phone Number

First 5 digitsLast 6 digits
Mobile Phone number

First 5 digitslast 6 digits
Date of Birth*

MonthDayYear
This is a physical course so please give details of any medical conditions that we should know about
please confirm none if appropriate.
Your work email if appropriate
Name of an emergency contact

First NameLast Name
Their contact number

First 5 digitsLast 6 digits
School or Group if appropriate
School or group address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Have you completed any of the following

Mountain leader trainingWalking Group Leader TrainingHill and moorland leader trainingLowland leader training
Please give brief details of experience that you already have
Thank you for registering to do the LEL course with us. Please note that this course requires a minimum number to run therefore we may not be able to run if that number is not reached. Provided the course is running we will be in touch soon and send you an invoice.

Please give details below of who to invoice and the best method of contact, we can send invoice by email or by post.
Invoice to:-

First NameLast Name
E-mail
Address

Organisation

Street Address

TownCounty

PostcodeCountry
Should be Empty:

Lowland Expedition Leader Application form