Dragon Boats New South Wales Inc.

(Incorporated under the Associations Incorporation Act, 1984)

(Registered Number: Y2086230)

Sweep Accreditation Questionnaire

& Checklist for Novice Training Assessment

Candidate Details

Full Name: / Gender:
Please Circle / D.O.B.
Day / Month / Year
M / F
Street Address:
Suburb / Town: / Post Code:
Contact Numbers: / Mobile: / Home: / Work:
Email Address:
For inclusion on Mailing List

Club Details

Club Name: / Region
Metro / NR / SR / WR
Member Number:
DBNSW ID Card (Tag) / DBNSW Member Since
Candidates Signature: / Date:

Reviewers Comments:

Test Coordinators Signature: / Date:
OFFICE USE / PASS / Attainment Date / Sweep Notified / Sweep Registrar Updated / DBNSW Database Updated / Certificate Created
Registrar Entry Date / n/a / Not applicable / Not applicable / Not applicable / Not applicable
Written Test Completed / Not applicable / Not applicable / Not applicable
L2 Practical Test Completed / Not applicable
Probationary Races Completed
Level 3 Status Updated in Registrar
Level 4 (L4) Advanced Status Achieved
Level 5 (L5) Sweep Mentor Status Achieved

DBNSW Inc Sweep Accreditation Questionnaire & Pre-Test Checklist

Please complete all sections

(Circle, Tick or Write Your Response, as required)

Sweep Training Experience

What is your current accreditation status ?
Re-Accreditation Due, Expired (Requires Re-Testing), Interstate Registration / Untested Novice / Required to
Re-Test / Interstate Sweep
How long have you been Dragon Boating ?
(ie Paddling) / Since / Years / Months
How long have you been Sweeping ? / Since / Years / Months
Name the person(s) who provided / supervised your sweep training (and/or has influenced your sweep development).
How often do you sweep a month ?
Indicate average number of sessions per month. / e.g. Sessions per Week / x4 weeks =
Have you maintained a Sweep Training Log ? / Yes / No / Hours Recorded (at Assessment)
Do you have a current Senior First Aid Certificate ?
Or an equivalent / or higher qualification. / Yes / No / Details / Expiry Date
Do you have a disability and/or injury that may affect your sweeping abilities; that DBNSW Inc should know about ?
If required, please supply further details on a separate page. / Yes / No / Condition Summary

Boat and Equipment Experience (tick all that apply)

Indicate the types of dragon boats you have had experience steering during your training. (tick each one separately) / BuK / EDBF / Geelong / Pont / Asian Style
Champion / Newcastle / Other
Swift / Race 1
Indicate Steering Arm configurations you have used. / Rowlock / Pins
(x2) / U-Bolt
(hoop)
Indicate the types of Sweep Oars you have used. / Long Type
(Surf Boat) / Short Type
(T-Bars)

Please contact your Regional Sweep coordinator if you require assistance with this Questionnaire & Checklist and/or would like to discuss another matter.

Sweep Coordinators:

Sydney 1 Robert Turnbull (Mavericks) Mobile 0411 188 484 Email

Sydney 2 TBA

North: NR1 Peter Richardson (CCDBC) Mobile 0408 972 952 Email

North: NR2 Anni Yaringa (GLPD DBC) Mobile 0408 265 955 Email

North: NR3 Robin Smith (Grafton DBC) Mobile 0412 647 622 Email

South: SR1 Ernie Panucci (Nowra DBC) Mobile 0417 144 409 Email

South: SR2 Pat Helmore (SWD DBC) Mobile 0427 961 626 Email

West: WR1 Phil Lambert (Colour City) Mobile 0408 968 254 Email

DBNSW Chief Executive Officer:

Glenn Tasker Mobile 0417 412 127 Email CEO

Sports House, Level 2 Phone 02 8736- 1284

Sydney Olympic Park NSW 2127 Fax

DBNSW Sweep Accreditation_Questionnaire_2016.07