Introduction to Premier Skills Registration Form

Introduction to Premier Skills Registration Form

INTRODUCTION TO PREMIER SKILLS REGISTRATION FORM

Sekolah Menengah Kebangsaan Wira Penrissen| 28 – 31January2016

KM 14, Jalan Kuching-Serian Kota Samarahan, Malaysia

The British Council engages with the community through a unique and innovative project, called Premier Skills. Premier Skills uses football in a fun way as a tool to engage with and develop the skills of young people.

This introductory four day,face-to-face training course will see participants work withPremier Skills Coach Educators from Malaysia.

As the Coach Educators come to the end of their course, they are looking to work with new community coaches to help improve their training skills.

We thank you for your interest in signing up to work with our Coach Educators.

Eligibility

  • Aged 18 and above
  • Has limited or no experience in football coaching
  • Have the intention to work in a community to use football as a tool to impact lives
  • Medically and physically fit enough to undergo the course. Candidates will need to sign a

declaration to confirm they are fit enough to participate.

  • Able to attend the whole duration of the programme, if selected

Application deadline is 15 January 2016.

All sections (including the measurements sheet) MUST be completed and emailed to

Please complete this form using block capitals

Section 1 – Candidate details

First name
Last name
Gender
Date of birth
Age
Correspondence Address
Phone (home)
Phone (work)
Mobile
Email
Current job title
Employer
Employer address
Dietary requirements or food allergies
Disabilities or medical requirements

Section 2 – Participation in the course

Please explain in no more than 100 words and provide examples in as much detail as possible:

How do you think you will benefit from the Premier Skills course?
How you will use what you learn on the course to benefit the wider community?
What are your future coaching aims/goals?

Section 3 – Candidate declaration

I confirm that I am physically fit and able to participate fully in the course and that I will take reasonable care to avoid injury to myself and other participants.

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Signature

Date:

I confirm that I know of no issue preventing me from working with children, and have never been subject to any police conviction or other disciplinary action relating to children.

…………………………………………

Signature

Date:

By submitting this form I agree to be photographed/filmed and for my photograph/film footage appearing on the British Council, Premier League and Premier Skills websites and on the project’s related materials.

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Signature

Date:

I confirm that I will not hold the British Council, the Premier League, and its officials, employees and agents for loss of life or property, damages, accidents or injuries to players, officials and spectators during the coaching clinic.

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Signature

Date:

Data Protection 1998 Notice: The British Council will use the information you have given on this form together with other information provided on feedback questionnaires to administer and evaluate the success of Premier Skills. Your information will be shared with individuals administering Premier Skills. Where you have provided information relating to any special needs we will only use this to ensure the equality of services provided and your safety. By submitting this form you consent to our processing sensitive personal data about you where this is necessary, for the purpose above.

All sections (including the measurements sheet) MUST be completed and emailed to

Premier Skills Measurement Sheet

SHIRT (please select a size)

S / XL / L / M / S

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Signature

Date:

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