RiderCoach Hiring and Candidate Application
Please complete the following information: (type or print)
Are you now, or have you ever been an MSF RiderCoach or Instructor? ____ RC # ________ Expiration date: ________
PERSONAL
Full Name _____________________________________________________________________________________
Address_______________________________________________________________________________________
_______________________________________________________________________________________
Employer___________________________________ Occupation _________________________________________
Home Phone (_______) _______ - __________
Cell Phone (_______) _______ - __________
Work Phone (_______) _______ - __________
Fax (______) _______ - ________
Email: ________________________________________________________________________________________
Are you 21 years of age or older? ❏ Yes ❏ No
❏ Male ❏ Female
EDUCATION
High School or GED ❏ Yes ❏ No
College/University Graduate ❏ Yes ❏ No If Yes, Major_______________________Highest degree earned__________
List other educational institutions you attended or any specialized training you have received. Be sure to identify any
certificates or advanced degrees. Use additional paper if necessary.
______________________________________________________________________________________________
______________________________________________________________________________________________
MILITARY If active duty, complete the following:
❏ Airforce ❏ Army ❏ Marines ❏ Navy ❏ Coast Guard ❏ Duty Title______________________________________
Rank _________________________ Organization & Office Symbol ______________________________________
How long stationed here? __________________________________
DSN Number_________________________________________ Extension _________________________________
Commercial Number ___________________________________ Extension ________________________________
MOTORCYCLE EXPERIENCE
Do you currently ride a motorcycle on a regular basis? ❏ Yes ❏ No - Approximate # of miles ridden per year ________
Motorcycle Operator’s License # __________________________________ State ______________________________
How many years have you had a motorcycle license or endorsement? _________________________________________
Have you ever had your license revoked or suspended? ❏ Yes ❏ No
If yes, When? ____________________________________ Where? __________________________________________
Why? ___________________________________________________________________________________________
________________________________________________________________________________________
How many years have you been a motorcyclist? __________________________________________________________
How many motorcycles do you own? ___________________________________________________________________
What type(s) of motorcycle do you own? ________________________________________________________________
What type of riding do you currently do? ❏ Dirt ❏Touring ❏Commuting ❏ Other / specify ________________________
Have you ever been involved in motorcycle racing? ❏ Yes ❏ No If yes, what type: ❏ Dirt Track ❏ Enduro ❏ Motocross
❏ Road ❏ Observed Trials
Are you familiar with the Motorcycle Safety Foundation:
Basic RiderCourse (BRC)? ❏ Yes ❏ No
Motorcycle RiderCourse (MRC:RSS)? ❏ Yes ❏ No
Experienced RiderCourse (ERC)? ❏ Yes ❏ No
Advanced RiderCourse/Sportbike Techniques (ARC/ST)? ❏ Yes ❏ No
Have you attended/completed any of the following motorcycle safety courses?
Basic RiderCourse (BRC) ❏ Yes ❏ No - If yes, when/where?________________________________________________
Motorcycle RiderCourse (MRC:RSS) ❏ Yes ❏ No - If yes, when/where?_______________________________________
Experienced RiderCourse (ERC, BRC2) ❏ Yes ❏ No - If yes, when/where?_____________________________________
Advanced RiderCourse/Sportbike Techniques (ARC/ST) ❏ Yes ❏ No - If yes, when/where?________________________
Other _____________________________________________________________________________________________
Describe in detail why you want to become an MSF-certified RiderCourse RiderCoach. Use additional paper if necessary.
(This is a screening process. What sets you apart?)
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Give a brief description of any other teaching experience.____________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
CHARACTER
Have you ever been convicted of (including a plea of guilty or no contest) a felony, or serious misdemeanor, other than a
minor traffic violation? ❏ Yes ❏ No
Are you now undergoing, or have you ever undergone treatment during the last five (5) years for the use of drugs, narcotics or
excessive alcohol use? ❏ Yes ❏ No
Do you have any medical condition that requires accommodation or that would otherwise impair your ability to safely perform
the duties of a RiderCoach? ❏ Yes ❏ No
If yes to any of the above, please explain fully: __________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
SPONSORSHIP
Are you being sponsored for this course? ❏ Yes ❏ No
If yes, by whom? _________________________________________________________________________________
What assistance will your sponsor provide?
________________________________________________________________________________________________
Where will you teach rider training after graduation? Have you talked to them?
________________________________________________________________________________________________
ACKNOWLEDGEMENTS
This application does not guarantee a position in a RiderCoach Preparation Course nor does it guarantee that the Motorcycle
Safety Foundation (MSF) will issue the applicant a RiderCoach Certification. If the applicant is offered a position in a
RiderCoach Preparation Course and the applicant successfully completes the RiderCoach Preparation Course, the MSF may
issue a RiderCoach Certification to the applicant. A RiderCoach Certification will only be issued upon execution of a
RiderCoach Certification Agreement between the applicant and the MSF. This application shall become an integral part of any
RiderCoach Certification Agreement that may be executed between the applicant and the MSF. Unless and until the MSF
issues a RiderCoach Certification to the applicant, the applicant is not an authorized, certified RiderCoach and may not make
any representations or perform any acts as such.
I certify that I have read this RiderCourse RiderCoach Preparation Candidate Application in its entirety, and the information
contained herein is true and correct and that I have not omitted any relevant information. I understand and agree that
falsification of any information provided herein, or the omission of any relevant information, will result in immediate
revocation of my MSF RiderCoach Certification.
Signature______________________________________________________________ Date ____________________
Requirements to become a North Carolina RiderCoach include:
a.
b.
c.
d.
e.
f.
g.
h.
Licensed, experienced motorcycle operator with a minimum of 3 years licensed riding experience.
High School diploma or equivalent.
21 years of age minimum.
Driving record with no more than 3 moving violations, no alcohol related traffic violations, and no driver’s license
suspension, revocation, or denial within the three years preceding the date of application to become a coach.
Graduate of a Motorcycle Safety Foundation Course (BRC, ERC or BRC2).
Have a recommendation from a current RiderCoach.
Certified in CPR.
You will be expected to be a role model for North Carolina motorcyclists, and as such, will be expected to wear the
proper gear, to include a DOT helmet, eye protection, sturdy over the ankle footwear, long pants of durable
material, long sleeved shirt or jacket and full fingered gloves; ANYTIME that you ride a motorcycle.
Do you meet these above requirements? ❏ Yes ❏ No If not, please explain: __________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Teaching a motorcycle safety course is physically demanding. It requires long hours, walking several miles in the course of a
day, bending and stooping to place cones, and sometimes the need to push inoperable motorcycles for distances up to ¼ mile.
Hot and cold weather conditions can add to the strenuous conditions you will encounter while teaching the course.
Do you feel you are physically capable of performing this job? ❏ Yes ❏ No
To maintain certification, RiderCoaches are required to teach a minimum of three classes a year in the N.C. Community
College System, and attend an annual update training session.
You will also be required to follow the MSF RiderCoach Rules of Professional Conduct.
You will also need to request, a copy of your driving record. In North Carolina, this can be done through the NC DMV
website. Dependent upon the state of residence and situation, it may take several weeks to obtain the record. Don’t delay the
submission of your RiderCoach application while you wait for the driving record. You can send the driving record at a later
date or bring it to the first night of your class. You will be required to submit a driving record every two years coinciding with
your MSF recertification.
Do you agree to these conditions? ❏ Yes ❏ No
If you are not currently certified in CPR, you must obtain this certification prior to teaching your first class.
I certify that I have read and understand the requirements to become a RiderCoach in North Carolina and that the information
contained herein is true and correct and that I have not omitted any relevant information. I understand and agree that
falsification of any information provided herein, or the omission of any relevant information, will result in immediate
revocation of my North Carolina RiderCoach Certification.
Signature______________________________________________________________ Date ____________________
2/15
MOTORCYCLE SAFETY FOUNDATION
RiderCoachSM and RiderCoach Trainer
RULES OF PROFESSIONAL CONDUCT
The rules of professional conduct for RiderCoaches and RiderCoach Trainers help ensure that MSF
RiderCoursesSM are conducted in a positive, efficient and professional manner. RiderCoaches and RiderCoach
Trainers agree to:
1. Conduct Rider Education Training SystemSM (RETS) courses and training opportunities in a manner that
meets the standards of the MSF curricula and only at recognized Rider Education Recognition Program
sites. RiderCoaches shall not conduct MSF training outside the US and its military installations without the
written approval of MSF.
2. Maintain a positive student environment.
3. Demonstrate safe riding habits and always wear protective gear when riding to, from, and during rider
training activities.
4. Currently operate a motorcycle on a frequent, routine basis.
5. Ride and drive free of alcohol and other drugs that cause impairment.
6. Maintain a good riding and driving record.
7. Complete RiderCoach and/or RiderCoach Trainer Professional Development as required by MSF.
8. Inform MSF of any personal address change, maintain a current email address, and complete MSF
RiderCoach or RiderCoach Trainer surveys promptly.
9. Conduct one’s self in a professional manner that includes: appropriate appearance and language; exhibiting
positive verbal and written messages; and positive interaction with others that is free from intimidation or
threat, consistent with MSF’s mission*.
10. RiderCoaches and RiderCoach Trainers are encouraged to support motorcycle safety programs and are not
prohibited by MSF from speaking to the media, participating in a legislative or legal process, or expressing
their opinions, as private citizens and experienced training professionals. However, RiderCoaches and
RiderCoach Trainers shall not present themselves as speaking on behalf of MSF while taking a public
position on safety or legislative issues or when addressing a public-policy forum.
11. RiderCoaches and RiderCoach Trainers are free to serve as an expert witness on motorcycle safety issues
based solely on their knowledge of motorcycling and familiarity with MSF’s curriculum. MSF RiderCoach
and RiderCoach Trainer certification in and of itself does not qualify a person as an expert witness.
MSF, in its sole discretion, may reject, suspend or revoke RiderCoach certification when MSF has determined that
the individual has acted or has threatened to act, in connection with training or otherwise, in a manner contrary to
MSF’s mission*.
I agree to abide by these Rules Of Professional Conduct.
Name (Print Clearly)
Date
Signature
*MSF Mission Statement:
To make motorcycling safer and more enjoyable by ensuring access to lifelong quality education and training for
current and prospective riders, and by advocating a safer riding environment.
Rev.3/14