Fast-Track Instructor Application

Upload Your Wilderness Medicine Instructor Credentials
Upload up to five wilderness medicine instructor credentials in JPG or PDF format. If you're not a certified WFA or higher instructor, stop now.*

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Your Contact Details
First Name*
Last Name*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Link to your LinkedIn profile if you have one - otherwise, enter NA.*
Are you a resident of the United States or a U.S. territory?*

Yes, I live in one of the 50 U.S. statesYes, a U.S. territoryNo
Select your U.S. territory*
Select your country*
Street Address 1*
Street Address 2
City*
State*
Zip*
I plan to (select ALL that apply):*

Offer classes on my own, or as part of my own businessOffer classes on behalf of another businessOffer classes as a member of a club or other orgOffer classes to SAR, EMS, fire or other emergency respondersOther - enter here
Please verify that you're human*
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Upload Your Wilderness Medicine Instructor Credentials