NEW GUIDE INDUCTION CHECKLIST FORM Induction DetailsGuide's Name:(Required)Date of Induction(Required) MM slash DD slash YYYY Person in charge of induction:(Required)Please SelectThomas Vialletet - DirectorDanielle Vialletet - DirectorSteve Moffat - Technical AdvisorOther - Please specifyOther Person in charge of induction name:(Required)Guide's InformationQualification:(Required)Please SelectIFMGA Mountain & Ski GuideNZMGA Climb GuideNZMGA Assistant Climb GuideNZMGA Ski GuideNZMGA Assistant Ski GuideNZMGA Alpine Trekking GuideNZMGA Assistant ATGDate of Birth:(Required) DD slash MM slash YYYY Phone(Required)Email(Required) Nationality:(Required)Residence Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Emergency Contact Full Name:(Required)Emergency Contact Phone Number:(Required)Relationship to the Guide:(Required)Please selectPartnerSpouseParentFriendOtherPlease specify:(Required)Guide's Quals Credentials Current and on file:(Required) Yes No Other Comment:Guide's Driving Licence Current and on file:(Required) Yes No Other Comment:Guide's First Aid Certificate Current and on file:(Required) Yes No Other Comment:Guide's Tax Status(Required)Contractor / Self-EmployedEmployeeGST Registered:(Required)YesNoIRD Number:Bank Account Details:Company SectionSummit Explorers Philosophy Understood:(Required) Yes No Other Comments:Guide/Summit Explorers Equipment Expectation Discussed and Understood:(Required) Yes No Other Comment:Contract Discussed and Signed:(Required) Yes Yes - Pending Signature No Other Comments:Guide's Role and safety responsibilities understood?(Required) Yes No Other Comments:Summit Explorers Coms discussed and reviewed:(Required) Yes No Other Comments:Helicopter Use and Client Safety Briefing Reviewed and Understood?(Required) Yes No Other Comments:Safety Management SystemSMS Read and Understood:(Required) Yes No Other Comments:Reporting Procedures Understood:(Required) Guide Briefing/Debriefing Trip Report Terrain & Conditions Report Near Miss / Incident / Accident Report Guide Feedback None of the above Additional Comments Comments:Emergency Procedures Understood:(Required) Guide in Field Procedures Office Systems None of the above Additional Comments Comments:Risk Register Read and Understood:(Required) Yes No Other Comments:Employment DeclarationGuide Consent:(Required) I have read, understood and signed off the SMS acknowledgment and agree to adhere to the SMSGuide Consent:(Required) I am physically fit to undertake my job and responsibilitiesGuide Consent:(Required) The information I have given are true and correct Δ
