2021 DOLI Scholarship Application
Thank you for your interest in the Diverse Outdoor Leaders Institute (DOLI)! Please complete the application below to be considered to receive a scholarship for the 2021 DOLI class. Please note, you must be at least 19 years old to apply for the scholarship.
Today's Date *
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Full Name (First Name and Last Name) *
Gender *
What are your preferred pronouns? (Ex: They/Them/He/She) *
What is your ethnicity? (if you are mixed, please choose more than one) *
Required
Present Address Street Number & Street Name *
Present Address City, State, & Zip Code *
Cell Phone Number *
E-mail Address (this is how you will be contacted - please ensure correct spelling) *
Tell us a bit about yourself and what inspired you to apply for this scholarship: *
How did you hear about Diverse Outdoor Leaders Institute (DOLI)? *
Are you available every Wednesdays from 6:30pm to 9:30pm between September 22, 2021 and November 19, 2021? We will be meeting in Pasadena, California. *
Required
Are you available for the following three weekend trips? Friday to Sunday 10/8 to 10/10, 10/22 to 10/24, and 11/5 to 11/7? Please note some of these weekend trips are mandatory in order to culminate from the program. *
Required
What known dates are you NOT available between September 22, 2021 and November 19, 2021? *
What is your current work schedule? (Include Days and Times) *
Current Employment Status
Clear selection
What is your highest level of education attained? *
What are the names of the high school, colleges, or other professional schools you attended?
What majors or degrees did you attain at the above named schools?
Do you have a Driver's License?
Clear selection
What is your current means of transportation?
Name of Employer (Relevant Work Experience #1) *
Employment Dates (Work Experience #1) *
Job Title (Work Experience #1) *
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company (Work Experience #1) *
Name of Employer (Relevant Work Experience #2)
Job Title (Work Experience #2)
Employment Dates (Work Experience #2)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company (Work Experience #2)
Name of Employer (Relevant Work Experience #3)
Job Title (Work Experience #3)
Employment Dates (Work Experience #3)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company (Work Experience #3)
Outdoor Leaders Assessment
The following questions will help us get a better understanding of your current knowledge and skills as an outdoor leader. Responding transparently helps us to support you as comprehensively as possible through the DOLI program. We welcome applicants who have limited, if any experience in any, some, or all of the below areas. A high level of experience is NOT required to be a part of DOLI. Our expectation is that the participant is committed to this experience and is willing to learn and grow.

Please be as honest as possible as you answer the following questions.
My confidence with understanding camping and backpacking equipment use: *
Required
My confidence with facilitating community builders with youth (team builders, ice breakers, fun activities): *
Required
My confidence with behavioral management (managing the behaviors of youth in a classroom or outdoor setting, ie: How to respond when a youth doesn't want to listen to you, etc.): *
Required
My confidence with planning and executing an outdoor trip with youth (Trip Logistics): *
Required
My confidence with the 7 Leave No Trace (LNT) Stewardship Principles: *
Required
My confidence with interpreting ecological concepts (ie: understanding the flowers, animals, and trees of a location): *
Required
My confidence with Wilderness First Aid: *
Required
My confidence with Map & Compass Navigation in a wilderness setting: *
Required
Are you fully vaccinated for COVID-19? *
If you are not vaccinated and don't plan on being vaccinated, are you willing to submit a COVID-19 test result to OBA every 2 weeks to keep yourself and all other participants safe? *
You will be required to wear a mask during our indoor classroom sessions & during travel in our vans to keep yourself and others safe from COVID-19 transmission. Are you comfortable with this requirement? *
I certify that the information I have provided in applying for this program is true and complete to the best of my knowledge and belief. I give DIVERSE OUTDOOR LEADERS INSTITUTE (DOLI) and its authorized agents permission to verify and/or disclose any information given in connection with this application for personnel/employment purposes. I understand that I must complete a Department of Justice (DOJ) Background Check prior to being able to work with youth. I further authorize any persons and/or organization identified on this form to provide information regarding previous employment or information regarding this application and release them from liability for providing such information. I acknowledge that any misstatement or omission in the application materials may be cause for elimination from further consideration or dismissal from the program. I hereby authorize any and all persons and agencies to furnish to DOLI any information, including documents in my personnel file, which may be necessary to verify this application and any other materials submitted, and hereby waive any rights of privacy to the information or documents which I may have under any federal, state, or local law, ordinance or rule. I also understand that an incomplete application packet may delay or prevent opportunities with the DOLI. This application and all supporting documents become the property of the Diverse Outdoor Leaders Institute and will not be released or returned. (By Clicking "yes" below, you will be agreeing to the above statement) *
Electronic Signature (Type your name below. This will be considered your electronic signature) *
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