Sample Parent Consent Form by 0PNlQ1

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									Job Application Form Template

The following form can be amended to suit the job being applied for, or to gain more or less information about
someone’s past experience. This example provides some ideas for the type of personal details you may need to
ask a coach before they are recruited. This form also gives the coach an opportunity to express their education
and training needs or wants. □

SECTION 1: PERSONAL DETAILS


1.    Title: □ Mr          □ Mrs          □ Miss            □ Ms            □ Other ………….......…
2.    First Name(s): ......………………………………………………………………………………………………….

3.    Surname: …………..……………………………………………………………………………………………….

4. Address: .......……………………………………………………………………………………………………….
……………………………………………………………………………………………………….....……………
……………………………………….............................................. Postcode: …………………………………

5.    Tel: (day) ............................................................ (eve) ...................................................................…..

6.    Tel: (Mobile) .......................................................… Fax: ............................................................………...

8.    E-Mail: ....................…………………………………………………………………………………………….….

9.    Date of Birth …………………………………………………………………………………………………

10.   Gender: □ Male                  □ Female
11.   Ethnic Origin:             □ White (UK)                  □ White (European) □ Irish             □ White (other)
                                 □ Bangladeshi                 □ Black African    □ Black (Caribbean) □ Black other
.                                □ Chinese                     □ Indian           □ Pakistani         □ Arab
.                                □ Asian (other)               □ Other …………………………………….……..
12.   National Insurance Number: ……………………………………………………...…………...... (if applicable)

13.   Occupation: .................……………………………………………………………………………………………

14.   Are you registered disabled?                       □ Yes            □ No
If Yes, please state disability/ special needs: ……………………………………………………………………
………………………………………………………………………………………………………......……………
………………………………………………………………………………………………………......……………
SECTION 2: COACHING QUALIFICATIONS/EDUCATION RELATED TO COACHING

15. Sporting Qualifications - Please list below any relevant National Governing Body coaching qualifications/
sports specific CPD (Continual Professional Development) Workshops you may have attended.

Sport             Level of         Date             Expiry date     Awarded by     Are you a         Are you an
                  Qualification    achieved                         (NGB)          tutor for         assessor
                                                                                   this award        for this
                                                                                                     award?




16.     Number of years coaching main sport:

        □ None         □ Under 1 yr         □ 1-5 yrs             □ 6-9 yrs               □ 10yrs+

17.     Are you currently affiliated to your NGB?        □ Yes        □ No
        If yes, through which Club/Organisation? .........…………………………………………………………………

18.     Do you belong to a coaches association?      □ None           □ NGB
                                                     □ NCF            □ Other ..…………………………….....…..


19.     Do you have insurance cover?        □ None            □ NGB

                                            □ Personal        □ Other .........……………………………....
20.     Please list below any National governing Body Awards you wish to take in the future

 Award/ Course                         Timescale in which to take the award
                                       0 – 6 months               6 – 12 months            12 months +




21.     Please list below any scUK Workshop/ Running Sport Workshop you have attended


 Workshop                                                                 Date attended




22.     Please list below any other relevant qualifications (e.g. First Aid)
 Name of Course               Date             Expiry Date
                              attended                           Awarded by (Organisation)
                                               (if applicable)




23.   Development Opportunities

Please indicate if you would be interested in any of the following areas.

 Area                                                                 Interested in attending (please tick)

 Sport specific technical/tactical workshop

 Fitness development workshop
 Sports Psychology workshop
 Nutrition workshop

 Sports Injury & Management workshop
 Observation and analysis Workshop
 Work with more experienced coaches
 Topical workshops e.g. Child Protection, Sport & the Law

 Disability Workshops




SECTION 3 – CURRENT COACHING ACTIVITIES

Please list below your current coaching activities

 Sport   Sex Coached            Age      People          Location              Name                           Days/time
                                                                                           Time
         (male/female/both)     group    withspecial     (club/school/NGB/     of          (during term/
                                         needs?          Local authority /     scheme      holidays/both)
                                                         other)




24.   Average number of coaching hours per week: .....................…………………………………………....……

26.   Are you:   □ paid          □ voluntary                □ both?
SECTION 4. REFERENCES

Please give details of two unrelated referees who can verify your coaching experience:

1.    Name: ............................………………………………………………………………………................…......

      Address: ..........................................................................................….…………....…………….................

      ............................................................................................................. Postcode: ....……………...………

      Tel: ............................................................................................................................................................


2.    Name: ............................………………………………………………………………………................…......

      Address: ..........................................................................................….…………....…………….................

         ............................................................................................................. Postcode: ....……………...………

      Tel: ............................................................................................................................................................




I confirm that all of the above information is correct and true to the best of my knowledge.



Signature: ………………………………………….………… Date: ………………………………………............…




Thank you for completing this Profile form, please return it to:



…………………………………………………………………………………………………………………………….

								
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