SCTA Foundation Teaching Professional Certification Scholarship Form

Applicant Information

Applicant Name

First NameLast Name

Birth Date

MonthDayYear

Years of Teaching Experience

Years of Playing Experience

Years of College Playing Experience

NTRP Rating

4.0, 4.5, 5.0

Gender

MaleFemale

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Your Best Phone Number

Ethnic Background*

List Other Ethnicity

Your Best Email

example@example.com

Club Name or Current Teaching Information

Club Name

Name of Current Club or Teaching InfoName of Employer (If applicable)

Employer Phone

Employer Email

example@example.com

Provide a Personal Reference (Different From Your Employer)

Personal Reference Name

First NameLast Name

Relationship

Personal Reference Phone Number

What is your personal mission or motivation to teach tennis? Please describe.

What are your top 3 personal strengths or characteristics as a teaching professional? Please describe an example or situation where those characteristics are assets.

Are you willing to fulfill all requirements by the SCTA Foundation, USTA and USPTA/PTR to successfully become certified teaching professional within one year from the starting date of your USPTA/PTR certification exam?

Are you willing to volunteer a minimum of 25 hours to make tennis an equal opportunity sport and bring tennis to under-served communities, events or programs within one year of certification? The under-served program(s) or event(s) of your choice can be anywhere in Southern California and must be pre-approved by the SCTA Foundation. Photos and written documentation are required as we will support and promote your efforts in our marketing campaigns.

Are you willing to provide updates on your status, photos and documentation that you have fulfilled (or in the process of fulfilling) all requirements as determined by the SCTA Foundation, USTA (background check and Safe Play), CPR/First Aid clearance, and USPTA/PTR certification standards?

Informed Consent and Acknowledgement I hereby give my approval for participation in any and all activities prepared by the SCTA Foundation during the length of this Teaching Professional Certification program. I give the SCTA Foundation the right to use my name and likeness in online, print and all marketing promotions. If I am selected for this scholarship, I will assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless the SCTA Foundation. and all its respective officers, agents, and representatives from any and all liability for injuries to said applicant arising out of traveling to, participating in, or returning from selected activities. In case of injury to the applicant, I hereby waive all claims against the SCTA Foundation. including all coaches, organizers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including tennis. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death. I agree to these conditions.

Please submit your resume in a PDF or Word Doc:

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.