Saint Lucia Olympic Committee



Application Form

Caribbean Coaching Certification Program

Please fill out and submit to the Saint Lucia Olympic Committee House or via email to sloc@candw.lc and to the Project Development Officer at andybehl@ .

Nominating Federation or Organization

← Athletics

← Basketball

← Body Building

← Boxing

← Cycling

← Football

← Golf

← Judo

← Karate

← Lifesaving

← Netball

← Rugby

← Sailing

← Shooting

← Squash

← Swimming

← Table Tennis

← Taekwondo

← Tennis

← Volleyball

← Ministry of Youth Development & Sports

← Ministry of Education – Primary School Teacher / Staff

← Ministry of Education – Secondary School Teacher / Staff

← Other Organization (Please Specify) ______________

|Applicant’s Information |

|Name: |

|Gender: |

|Age: |

|Date of Birth (DD/MM/YYYY): |

|Years Coaching or Involved in Relevant Sport Leadership: |

|Primary Geographic/Political District of Anticipated Coaching: |

|Primary Phone Number: |

|Primary Email Address: |

|Applicant’s Sports Background / Past Involvement in Sport |

|We would like to understand if this applicant has any prior relevant experience in their communities. |

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|(For example, what has the applicant’s involvement in sport been over the past two years? If applicable, what groups or individuals has this person worked |

|with? Have there been any success stories or notable performances through the work with this applicant? How many days/hours was the applicant involved?) |

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|12-Month Action Plan |

|As a nominating organization, there is a responsibility to help ensure the resources dedicated towards coaching development are put into application and the |

|coaches have a plan in place that will provide practical experience to complement the theory work of the CCCP programme. Successful implementation would also |

|be a favorable consideration in applications for future coaching development initiatives. |

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|Brief quarterly reports will be expected to be submitted from the nominating organization for each participating coach to ensure follow-through of applicants,|

|highlight successes and opportunities for improvements in the coaching ecosystem. These quarterly submissions are anticipated to be dueJune 30 |

|(2020);September 30 (2020); December 31 (2020) and March 30, 2021. |

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|What is the plan for how this applicant will apply their skills immediately and over the next 12 months? |

|(For example, what national or local group, club, school or programme will they be a part of? Is there a mentor, supervisor or leader that this coach will be |

|collaborating with? Broadly, what is the anticipated schedule of training these coaches will be guiding and supporting? Where will this coach be serving? What|

|are expected results from this coach’s work? If applicable, please highlight any resources or collaborating programming from the organization that will |

|contribute to the efforts and action plan with the coach.) |

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|Statement of Purpose |

|Please include a statement of purpose from the applicant describing why the applicant is seeking this certification and how it will impact that applicant’s |

|future contribution to their relevant community. |

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|Confirmation of Nomination |

|Both the applicant and the nomination organization have read and understood the Saint Lucia Olympic Committee Inc’s intent and relevant policies regarding the|

|Caribbean Coaching Development Program course and agree to deliver the expected action and relevant supporting documentation in the timeline stipulated in |

|this application document. |

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|The applicant acknowledges that a failure to attend or a lack of full participation throughout the CCCP session will result in potential loss of future |

|development opportunities offered to that individual. |

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|____________________________ ____________________________ ______________________ |

|Applicant Signature Nominating Organization Representative Name & Signature |

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|___________ |

|Date |

Applications should be submitted to the Secretary General of the St. Lucia OlympicCommittee Inc. at SLOC@candw.lcand to the Project Development Officer at andybehl@.

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