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FINA National Federations Development Handbook

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The <strong>National</strong> Federation of:<br />

Participant Information<br />

Surname(s) First Name(s)<br />

Date of Birth Age <strong>National</strong>ity<br />

Marital Status Single /<br />

Married<br />

Address for<br />

Correspondence<br />

Discipline:<br />

(Please check one)<br />

Discipline level:<br />

Current coaching certification<br />

level:<br />

(<strong>National</strong> Level, <strong>FINA</strong> Certified<br />

Level)<br />

Active coach? Yes/No Date of last activity<br />

<strong>FINA</strong> NATIONAL FEDERATIONS DEVELOPMENT PROGRAMME 2010<br />

<strong>FINA</strong> SCHOLARSHIPS FOR COACHES<br />

Participants Application Form<br />

Sex M / F Title Mr / Mrs / Ms / Other<br />

Telephone<br />

Fax<br />

E-mail<br />

□ Swimming □ Open Water Swimming □ Diving<br />

□ Water Polo □ Synchronised Swimming<br />

□ Beginner □ Intermediate □ Advanced<br />

Education: General and Sport Training (Diplomas, Certificates, etc.)<br />

Year Training Diplomas awarded

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