CHEER: Practical Field Experience Validation Form

ICU CSC CHEER Practical Field Experience Validation Form
This form is intended to be filled out by the SUPERVISOR.

Supervisor: by submitting this form on behalf of the coach, you are confirming they have completed the required hours for their candidacy.
Supervisor Name*

First NameLast Name
Supervisor Email*
example@example.com
Coach Name*

First NameLast Name
Coach Email*
example@example.com
ICU Coaching Skill Credentialing Facilitator Name or Provincial Sport Organization *

First NameLast Name/Provincial Sport Organization
ICU Coaching Skill Credentialing Facilitator Email or Provincial Sport Organization*
example@example.com
By selecting this box, I, the supervisor, am verifying that the coach has completed coaching hours in the following level(s):*

200 hours of Novice & Intermediate (Required to credential at the Median Level)150 hours of Median (Required to credential at the Advanced Level)150 hours of Advanced (Required to credential at the Elite Level)150 hours of Elite (Part I: Required to credential at the Premier Level)100 hours of Premier assistant coaching, shadowing, or athlete experience (Part II: Required to credential at the Premier Level)
Upload Hours Tracking Sheet*

Browse Files
Proof of coaching hours must be provided Cancelof
This coach has expressed their intention to credential up to the following level:*

NoviceIntermediateMedianAdvancedElitePremier
Organization Name*
Employee has been employed since*

MonthDayYear
Date
When you click submit, a copy of this form will be sent to the director of the ICU CSC Cheerleading program, the coach, supervisor, and the facilitator or Provincial Sport Organization of the upcoming Credentialing session. This is for record keeping and verification purposes.
Should be Empty:

ICU CSC CHEER Practical Field Experience Validation Form