| POSITION
APPLIED FOR: CLUB ENGLAND COACH SCHOLAR |
| PERSONAL
DETAILS |
| LAST NAME: |
FIRST NAME: |
TITLE: |
| HOME
ADDRESS:
POSTCODE: |
COACH
EDUCATION AND QUALIFICATIONS
Please list below your most advanced/highest National Governing Body award that you
hold relevant to this application and other courses which you have attended in the last 2
years |
| QUALIFICATION/MODULE
NAME:
|
DATE ACHIEVED:
|
EXPIRY DATE:
|
| OTHER INFORMATION RELATING TO COACH EMPLOYMENT HISTORY: |
| |
IS THE CLUB YOU ARE CONNECTED TO A CLUB ENGLAND
CLUB? YES  NO |
| If yes, what is the name
of club? |
REFERENCES
Please give names, addresses and position of two referees to whom reference may be
made in your capacity as a coach |
| 1.
|
2.
|
| DECLARATION: |
| I certify that all the
facts/details stated on this form are correct. I understand that the Eastern Volleyball
Federation reserves the right to verify all information contained in this application
through the use of background checks before or after commencement of scholarship. I
authorise the Eastern Volleyball Federation AND/OR Volleyball England to obtain references
from any referees. Signature (electronic):
Date: |
| CLOSING DATE FOR APPLICATIONS: 13TH OCTOBER 2008 |
ESSEX
VOLLEYBALL ASSOCIATION