Application to be Instructor, Trainer or Volunteer

Name of Applicant: *

First

Last

Address: *

Full address

Post Code: *

Home Phone Number:

Mobile Phone Number:

Email:

Qualifications Attained:

Dinghy Instructor

Expiry Date:

Qualifications Attained:

Powerboat Instructor

Expiry Date:

Dinghy Sailing Qualifications Attained:

Senior Instructor

Expiry Date:

Racing Qualification Attained:

Level 2 Race Coach

Expiry Date:

Other Qualifications:

First Aid

Expiry Date:

Other Checks Carried Out:

DBS Check:

DBS Issue Date::

DBS Certificate Number:

DBS Issuing Organisation:

RYA Membership Number:

Please detail your previous Instructing experience (locations, dates, types of boat, age of students, any advanced qualifications):

Please detail any work/voluntary roles you have held which involve work with children:

Referee 1 Name: *

First

Last

Please give names and addresses of two people who can be asked to provide a reference. References from relatives will not be accepted.

Address: *

Email *

Phone Number:

Capacity in which known to you: *

Referee 2 Name: *

First

Last

Address:

Email *

Phone Number:

Capacity in which known to you:

CONFIRMATION: *

By ticking this box you confirm that you will:

• Provide original qualification certificates for inspection.
• Provide photographic identification for inspection.
• Complete the self-declaration form below.
• Agree to have a Disclosure and Barring Service (DBS) check carried out.
• Read and confirm agreement in writing to the Club Safeguarding Policy and Code of Conduct.
• Read and confirm agreement in writing to the Club Operational Procedures.
• Attend an induction with either the Chief Instructor or Principal.

Data Protection:

By ticking this box I agree to the data protection implications:

In order to recruit to this role Swarkestone Sailing Club will process personal information given in connection with this application. Information relating to the successful applicant will form part of personnel records. All personal data will be handled in accordance with GDPR regulations.

Applicant’s Declaration:

By ticking this box I declare that to the best of my knowledge the information given on this form is correct and understand that misleading statements or deliberate omission may be sufficient grounds for cancelling any appointment arising from this application.

Enter Applicant's Name: *

First

Last

Date: