Application Form
to attend

 Level 1 Coaching Course

 

All applicants must complete and return this form & bring the necessary documents to the course,

Please ensure you include information such as middle names, post codes, previous names etc.
 Failure to give such information can delay your CRB check.

Title Mr, Mrs, Miss, Ms etc
Name of Applicant Please include any middle names
Any Previous Names
If you have had previous names please give dates used from and up to.
Current Address (Please ensure you include Post Code)
Telephone	Home Mobile
E-mail (please supply if you have one)

 

 

 

 

 

 

 

 

In order to improve contact between coaches and the FWA we ask that you enclose your e-mail address.

Please enclose payment of £125 per course attendee, made payable to The Federation of Welsh Anglers (FWA) unless to be paid by group organiser/a trust/angling club etc.  Your place is not secured until your payment has been received.
  (PLEASE TICK METHOD OF PAYMENT)

Cheque
Postal Order
To be paid by group organiser/club Please complete details of person/organisation below if they are paying course fee
CONTACT DETAILS OF GROUP ORGANISER/CLUB etc (if applicable)  to be invoiced    NAME      ________________________________________________________ ADDRESS _________________________________________________________ TEL NO:    _________________________________________________________ EMAIL ADDRESS:

 

                                            

   Additional Information

 

What is your preferred angling discipline?   Coarse, Game or Sea……………………………..

There will be a written exam at the end of the Level-1 course, if for any reason you would prefer the exam to be given verbally by a tutor, with the tutor writing you answers on the exam sheet please tick this box.

Are you Welsh speaking?………………………………………………………………………………………………

Do you give your consent for us to publish your contact details on our website and other promotional materials as an active angling coach?……………………………………………………………………………

What is your preferred contact telephone number?………………………………………………………

What is the name of the Club you belong to and the area it is in?……………………………….
………………………………………………………………………………………………………………………………………….

Would you be willing to assist in coaching at regional events, outside of your own club?..............

The course fee includes an embroidered coach shirt.
What is your shirt size?      XXL      XL      L       M

 

Support is available to help with costs of attending this course.  Grants through your club or organisation can be obtained through your Local Authority Community Chest Grant Scheme.  Your club or organisation can also obtain funding for fishing tackle and equipment, health and safety equipment, first aid kits as well as other coaching related courses such as First Aid, Sport Development and Child Protection.  In the first instance contact your local Council for more information and if you have any other queries then please contact our National Angling Coaching Co-ordinator:-

Helen Pearce
9 Maes Afallen
Bow Street
Aberystwyth
Ceredigion
SY24 5BL
Tel. 01970 626888 daytime or 01970 820063 evenings
Email: helen.pearce@btconnect.com

We have 3 Regional Co-ordinators, details as follows:-

North Region
Nick Massey, 17 Gilbert Street, Holyhead, Anglesey, LL65 2NR
Tel. 07748701326
Email: zandorion@aol.com

 

East Region
Andy Rawlings, 96 Maple Road South, Sebastopol, Pontypool, Torfaen, NP4 5AR
Tel. 07969919362
Email: cwmbranaa@tiscali.co.uk

Please send your completed application form to the relevant Regional Co-ordinator

 

CRB Check Details

All applicants must complete the following & bring it along to the Course

1.   Do you hold a CRB certificate   Yes /  No    (delete as appropriate)

(If yes please complete)

Date of issue
Disclosure number

Please provide copy of your CRB disclosure certificate

If you do not have a CRB disclosure certificate please complete the following

2.   How long have you lived at the above address:                             years                       months

• If less than 5 years please give previous address including post code

Please give dates when you lived at this address and dates when you left.

4.

Date of Birth

 

5.   You must include your National Insurance Number otherwise your application can not be completed.

National Insurance Number

• Please provide details of place of birth

Town / City
County / District
Nationality

If you were not born in the UK please state country of birth

• Please provide contact telephone number

Home:                                                                Mobile:

• Please provide one of the following proofs of identity on the day of the course . Please note we need to see the original document. These will be returned to you on the day of the course. If you do not have one of these types of identify proof we will need to see a birth or marriage certificate.

Passport Number		Verification by Course organiser (for official use)
Nationality		Signature of Organiser______________________ Name of Organiser      ______________________
Date of Issue
Date of Expiry
Driving Licence Number		Signature of Organiser ______________________   Name of Organiser     _______________________
Licence Type	Paper  / Photocard  (please delete that does not apply)
Country of Issue
Valid From
Expiry Date

9.   Please provide at least 3 different recent utility bills, gas, electric, telephone, mobile, or letter from local authority eg Council Tax Bill. Please note that photocopies are not acceptable. These will be returned to you on the day of the course if provided.

Description of Document	Signature of Course Organiser For official use
1.
2.
3.

10.  

Please give details of membership to any angling governing body, club, association etc.

11.Please tick the licence category you are applying for;

Level 1 Angling coach
Level 1 Coaching assistant

Please state the preferred date that you would like to attend a level 1 course.

 

 

 

 

 

 

 

 

WHAT HAPPENS NEXT- please retain this page

• Make sure you bring to the course:

• a passport sized photo
• documents and proof of ID as stated on the CRB check form

 

• You attend the course and hopefully pass!

 

• Please note at this stage you are not a licensed Level 1 coach until you have been CRB checked

• The information you have provided on this form will be used to complete a CRB application form

 

• The CRB check will be made

• If your CRB check is acceptable, we will welcome you on board as a licensed FWA Level 1 coach

 

• A Level 1 coaching license will be issued to you

• You are free to coach on a club basis, while also being able to coach at non-club events(eg arranged by the Environment Agency) where there is a Level 2 coach present in overall charge

 

• An annual fee is required each year to cover your insurance as a coach and administration fees. A request for this will be sent out to you each year

 

Despite attending the course, that person is not a licensed coach until the CRB check has been made. Unless a coach has been CRB checked and approved, no coaching license will be issued and insurance cover is invalid.

A passport sized photo is required in order for us to include on your licence, please bring this with you to the course along with your proof of ID and other documentation.