UKCC LEVEL 3: RFU ADVANCED COACHING AWARD
APPLICATION FORM FOR 2016/17
Please complete this application form fully and submit along with the following:
1)
Written confirmation (email or letter) from your club/school that you are Head Coach/Programme Leader in the
XV a side game – this is essential if you are to demonstrate all competences.
2)
Evidence of attendance at three or more of the following advanced CPD series, comprising at least two from:
Planning & Periodisation, Player Profiling and Game Planning, plus one from: Goal Setting and Performance
Analysis. You can find details of current courses online at www.englandrugby.com/my-rugby/courses/search.
3)
Completed Player Profiling task using the template provided for 4 positions (Hooker, Blind side Flanker, Fly
Half and Right Wing). Please ensure you are using the task that has been set for 2016 and not a previous
template.
4)
Evidence that you have completed the HEADCASE ONLINE CONCUSSION EDUCATION COURSE. Please see
the Application and Admission Details document for full details.
5)
Full Coaching CV.
6)
Submission of a 15-20 minute long video clip, which shows you coaching “Go forward and support” from
phase play. Please see the Application and Admission Details document for full requirements.
Please complete all boxes. Applications will not be accepted if they are incomplete or illegible.
1. Course Details
Course Name
Preferred Course Venue
(please delete as applicable)
UKCC Level 3: RFU Advanced Coaching Award
North Course
South Course
Pro Players Course
2. Name of Club / School
Name of Club
Name of School
Constituent Body
(e.g. Leicestershire)
3. Personal Details
First name
Surname
Date of Birth
(DD/MM/YY)
Gender
Full Address
Postcode
Home Tel. No.
Version: October 2015
Mobile
Age
Email Address
4. Ethnicity / Disability
Ethnicity
I would describe my ethnic origin
as:
Disability
This will help course staff to
support your learning needs,
where relevant.
Do you consider
yourself to have a
disability?
If yes, what is the nature of
your disability?
Hearing
Visual
Learning
Mobility
Dyslexia
Other
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Comment
I confirm that I have read, understand and agree to the details contained in the Application and Admissions Details of the Level 3
coaching course:
Signed
Date
Financial Implications for Applicants Not Attending Courses
If an applicant does not attend the course or gives less than 48 hours’ notice then no refund will be given.
If an applicant gives between 2 and 14 days’ notice, the applicant can be relocated to another course providing they pay a £25
administration charge, there will be no refund.
If an applicant gives more than 2 weeks’ notice, they can be offered either relocation to another course at no charge, or a refund
of 75% of the course cost.
Nature of the Coaching Courses
Attendance on coaching courses will require some practical involvement to assist the coaching process. Please raise any issues
that could affect your health with either the administrator or your Coach Educator on arrival at the course.
Version: October 2015