Instructor Expression of Interest Form 2023-24

PLSLSC Instructor Expression of Interest Form 2025/26
During the 2025-26 season, Point Lonsdale SLSC will train over 300 Nippers in addition to 96 Junior Bronze Medallion and Surf Rescue Certificate (SRC) candidates. These training programs are all dependent on volunteer instructors from our Club, working in teams with other qualified and experienced members.

Instructing is a rewarding and enjoyable experience, and is a great way to develop your own lifesaving skills and make new friends.

If you are interested in volunteering as an instructor for this season please complete this form ASAP.

PLEASE NOTE:

INSTRUCTORS AND HELPERS MUST BE 2025/26 MEMBERS AND MUST BE CURRENT IN THEIR AWARDS (I.E REQUALLING YOUR AWARDS AT SKILLS MAINTENANCE - click here for info on skills maintenance sessions)

**Due to changing program requirements, completing this form does not lock you into a role - it just indicates that you are interested. We will email those who completed the form closer to the commencement of the programs.
Email*
example@example.com
You must supply an email address that you will regularly monitor. This is the primary method of important communications for instructors.
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
All members who are aged 17+ on or before 30 September 2008 must have a valid Working With Children Check (WWCC) that lists Point Lonsdale SLSC.
Do you have a current Working With Children Check (WWCC) that lists Point Lonsdale SLSC?*

Yes, and I have provided my WWCC information to the Point Lonsdale SLSC Office.No, but I will apply for a WWCC and provide my application information to the Point Lonsdale SLSC Office.
What awards do you hold?*

Surf Rescue Certificate (SRC)I do not have my SRC, but I will hold it before Nippers beginsBronze MedallionI do not have my Bronze Medallion, but I will hold it before Nippers beginsIRB CrewIRB Driver
Do you hold a Training Officer Certificate (TOC) Award?*

YesNo
If you are unsure, you won't have this award already.
Phone Number*
Please enter a valid phone number.
Please list any dietary requirements you may have (leave blank if none):
e.g. vegetarian, nut allergy
Shirt Size*

XSSMLXL
SRC Instructor

Including Water Safety, Group Leader, Helper, Trainee Trainer/Assessor/Facilitator and Trainer/Assessor/Facilitator
SRC Dates: Saturday 20 December - Monday 22 December 2025
- Must be 16+, hold a current Bronze Medallion and be an active (patrolling) member.
- Must be available for at least one session.
- Previous instructing, patrol leadership experience & further training is helpful.
- Note: Participating as a SRC Instructor does NOT count toward the calculation of total patrol hours.
Are you interested in being a SRC Instructor?*

YesNo
Briefly, list any relevant prior experience and what you can bring to the SRC Course as an instructor:
Junior Bronze Medallion (JBM) Instructor

Including Water Safety, Group Leader, Helper, Trainee Trainer/Assessor/Facilitator and Trainer/Assessor/Facilitator
JBM Dates: Saturday 13 December - Wednesday 17 December 2025
- Must be 16+, hold a current Bronze Medallion and be an active (patrolling) member.
  Must be available for at least one session.
- Previous instructing, patrol leadership experience & further training is helpful.
- Note: Participating as a JBM Instructor does NOT count toward the calculation of total patrol hours.
Are you interested in being a Junior Bronze Medallion Instructor?*

YesNo
Briefly, list any relevant prior experience and what you can bring to the JBM Course as an instructor:
Nippers Instructor

Including Junior Instructor (13 yr old no Water Safety), Instructor & Head Instructor (Instructors 14+ double as Water Safety)
Nippers Season: Sunday 28 December 2025 - Saturday 10 January 2025
- Must be 13+, hold a current SRC or Bronze Medallion award, be an active (patrolling) member and available for most or all sessions.
- Previous instructing, patrol leadership experience & attaining further awards is helpful.
- COMPULSORY Instructor Training: Saturday 27 December 2025 from 9:00am - 1:00pm at the PLSLSC Clubhouse
- Note: 50% of Nipper training hours will count towards total patrol hours but they are NOT included in the Active Member minimum patrol requirement of 20 hours patrolling at the Back Beach.
Are you interested in being a Nippers Instructor?*

YesNo
Starfish Nippers is the lifesaving skills program designed for children and young adults (6 years and older) with a disability: http://www.starfishnippers.com.au/
Are you interested in instructing Starfish Nippers?*

YesNo
Additional Comments
Thank you for volunteering to be an Instructor for the 2025/26 season.

Please make sure you save any of the relevant program dates in your calendar!
Should be Empty:

PLSLSC Instructor Expression of Interest Form 2025/26

SRC Instructor

Junior Bronze Medallion (JBM) Instructor

Nippers Instructor

Thank you for volunteering to be an Instructor for the 2025/26 season.