Coach Award Check-in For use by candidates in England, Scotland, Wales and Northern Ireland PLEASE COMPLETE ALL SECTIONS ON THIS FORM IN FULL AND RETURN, TO YOUR HOME NATION HEAD OFFICE Assessment Check-in is currently only available for the coach award. Forename: .............................................................. Surname: ............................................…………………. Membership No: ..................................................... E-mail: ..................................................................... Assessment Discipline & Environment Please complete this form if you wish to Check-in for your Coach Award Assessment. ☐ Canoe Coach (Sheltered Water) There is no requirement to send us copies of ☐ Kayak Coach (Sheltered Water) British Canoeing Qualifications, Awards or ☐ Canoe & Kayak Coach (Sheltered Water) Training as these are recorded on your ☐ Freestyle Coach British Canoeing record. ☐ Open Water Canoe Coach If you have recently updated your First Aid, ☐ Polo Coach safeguarding training or wish to include ☐ Racing Coach copies of your certification please return ☐ Sea Kayak Coach copies with this form to the postal or email ☐ Slalom Coach address for you Home Nation office listed ☐ below. Surf Kayak Coach ☐ White Water Canoe Coach Assessment Tasks ☐ White Water Kayak Coach I will be presenting the L2 Workbook in place ☐ Wild Water Racing Coach of e-learning. YES ☐ Open Water Canoe Coach (Advanced Water) NO ☐ Sea Kayak Coach (Advanced Water) I will be presenting the L2 portfolio in place ☐ Surf Kayak Coach (Advanced Water) of the Pre-Assessment Discussion Task. ☐ White Water Canoe Coach (Advanced Water) YES ☐ White Water Kayak Coach (Advanced Water) NO CANDIDATE DECLARATION I understand that by submitting this form my data will be processed in line with the British Canoeing Data Protection Policy for the purpose of confirming I am eligible to attend the assessment as indicated above, once confirmation is given this record will be securely destroyed. SIGNATURE: ……………………………………………………………. PRINT NAME: ………………………………………………… DATE: ………………………………………… For Office Assessment Check Approved Use Only Assessment Check-in Expiry Date………………………………………… British Canoeing: Canoe Wales: Canoe Association of Scottish Canoe National Water Sports Centre, Canolfan Tryweryn, Northern Ireland: Association: Caledonia Adbolton Lane, Frongoch, Unit 2 Rivers Edge, House, 1 Redheughs Rigg, Holme Pierrepont, Nottingham, Bala, 13-15 Ravenhill Road, Edinburgh, EH12 9DQ NG12 2LU Gwynedd, Belfast, [email protected] [email protected] LL23 7NU BT6 8DN [email protected] [email protected] .