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* 1. Name

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* 2. Class Year

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* 3. MMC Guide Status?

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* 4. How long have you been climbing? Indoor climbing certainly counts, but we're particularly interested in your outdoor experience.

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* 5. At what grade do you feel consistently comfortable top roping outside? (i.e. 5.6, 5.8+, etc)

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* 6. On a 1-10 scale, 1 being no experience what so ever, and 10 indicating you could teach this skill tomorrow, please indicate your comfort with the following:

  1 2 3 4 5 6 7 8 9 10
Belaying in a top rope environment
Belaying a leader
Belaying from above
Placing artificial protection
Building anchors with bolts
Building anchors from trees
Building anchors with artificial protection
Leading sport routes
Leading with trad gear
Cleaning a sport anchor
Rappelling
Extended rappelling with a backup (third-hand, autobloc etc.)

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* 7. If there are particular skills or goals you have related to this seminar, please tell us here!

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