Instructor/ Coach Application Form
2021 Season
Name:
*
First Name
Last Name
Mobile Phone Number:
*
-
Prefix
Phone Number
Email:
*
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of birth:
*
-
Day
-
Month
Year
Date
Instructor/ coaching qualifications:
Give date and venue of each qualification with each
Previous relevant work experience:
Classes of boats sailed:
First Aid qualification:
First Aid expiry date:
-
Month
-
Day
Year
Date
Powerboat Qualifications:
Have you completed Safeguarding 1 course?
Yes
No
Where did you complete Safeguarding 1?
Location of course
Available for work during:
March-May
June
July/ Aug
Sept-Nov
Weekdays
Evenings
Weekends
Indicate if you have:
VHF Radio Cert
Instructor Pre-entry Cert
References
Please complete in full
Sailing Instructor Ref 1:
Include (i) name, (ii) club/organisation name, (iii) email address and (iv) phone number
Sailing Instructor Ref 2:
Include (i) name, (ii) club/organisation name, (iii) email address and (iv) phone number
Personal reference:
Include (i) name, (ii) club/organisation name, (iii) email address and (iv) phone number
I declare that all of the above information is true and I give permission for any enquiries to be made to establish my qualifications, experience or character.
*
Confirm
Submit
Should be Empty: