make a difference by AU8870


									make a difference!
Still interested?
Complete the attached application and return it

      Northern Virginia Community College
 Continuing Education & Workforce Development
             ATTN: David Hepburn
            3001 N. Beauregard Street
              Alexandria, VA 22311

You will be contacted by a chief instructor to
discuss your application and arrange for a riding
evaluation. If you are accepted as an instructor
candidate, you will be notified of the dates ,
location and registration fee for the instructor
preparation workshop.

Once you have passed the instructor preparation
workshop, you'll be eligible to teach at DMV-
approved training centers, usually located at
community colleges around the state.

You can make the difference!
                     If so, you can                                                                 Instructor Candidate Application
The Virginia Rider Training Program                                       Personal Information                                  Motorcycle Experience (concluded)
i s looking for a few good motorcyclists to
train other Virginians to be skilled and safe           Name:                                                         Estimated total number of miles ridden on a motorcycle
motorcyclists. Requirements:                            Street Address:
                                                        City:                                                         List currently owned motorcycles by brand and
     Above average riding skills                       State:
                                                        Zip:                                                          Check your current types of riding:
                                                        Phone: (home)                                                              off road                    touring
     Excellent communication skills                                                                                               commuting                   sport riding
                                                        Phone: (work)
                                                        Birth Date:                                                   Have you raced competitively?            Yes      No
     A strong desire to share your                                                                                   If yes, what type of racing?
                                                        Social Security Number:
       experience and safe riding skills with                                                                                      dirt                        flat track
       other beginning and experienced                                                                                             road race                   enduro
                                                        Are you currently in the military?    Yes      No
       riders.                                                                                                        Have you taken any Virginia Rider training Program or
                                                        Branch of service, if yes:
                                                        Station, if yes:                                              Motorcycle Safety Foundation courses?
The Virginia Rider Training Program offers classes in                                                                                                          Yes      No
conjunction with the Virginia Community College                                                                       If yes, please list locations and dates:
System to beginning and experienced riders throughout                   Educational Background
Virginia. Skills learned in these classes help riders
prevent accidents - making the road safer for           Year of high school graduation or GED                         Are you currently teaching a rider education
everyone. But we need help from the experts.                                                                          course?                          Yes     No
                                                                                                                      If yes, please list location, sponsor and describe the
                                                        Advanced study?                 Yes      No                   curriculum: Use separate sheet if necessary.)
Interested?                                             Graduated?                               Yes        No
The Department of Motor Vehicles organizes
instructor preparation workshops throughout the         Degree and major, if yes:                                     If you become an instructor, in which areas of the state
state for riders interested in becoming certified                                                                     would you be able to teach?
Motorcycle Safety Foundation instructors. Each          Other education or training, including degrees or certifi-
workshop is offered on three consecutive weekends.      cates:                                                        Please explain why you want to become a Virginia Ride
Courses are taught by chief instructors certified by                                                                  Training Program instructor. (Use separate sheet if
the Motorcycle Safety Foundation.                                                                                     necessary)
                                                                         Motorcycle Experience
It's not easy.
The workshop is an intensive 50 hour program
which covers every aspect of safe motorcycling from     Driver's license number:                                      Signature:
proper riding gear and motorcycle preparation to        State:
advanced emergency riding maneuvers. Instructor         Motorcycle endorsement?               Yes     No              Date:
candidates must attend the entire workshop and should   Has your license ever been revoked or suspended?
plan on spending time on outside study. At the end                                            Yes     No               This application does not guarntee a position in an
of the course, you'll teach a class of novice riders
                                                        If yes, please explain:                                                  instructor preparation course.
under the supervision of a chief instructor.
                                                        Do you currently operate a motorcycle?                        If you have any questions contact the Virginia Rider
                                                                                              Yes     No                              Training Program at
                                                        Years of riding experience:                                                      (804) 367-1813

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