Keel and PowerboatInstructor Recertification Application

Send Recertification Application Form along with $75 administration fee to Sail Canada.

Current Level of Certification: ______

Date of Last Certification/Recertification______

Circle one: Learn to Cruise Learn to Power

Name: ______Instructor No.: ______

Address: ______City: ______Province: ______

Postal Code: ______Email: ______Phone: ______

Background (excerpt from Training Division Re-certification Policy):

LTC/P Instructor recertifies at existing level by providing proof of active coaching / instructing during the period of certification as follows:

  • LTC/P Instructors: minimum average of 10 days OR 3 courses per year (of which 50% is on water instructing time);
  • LTC/P Special Endorsement Instructors: average of 1 course per year

If minimum activity is not met, LTC/P Instructors must take full clinic at existing level; LTC/P Special Endorsement Instructors must successfully re-write exam and submit written endorsement from their PSA.

Summary of Teaching Experience

Table 1. Sailor Development Program Courses

Organizing School/Club / Course
(i.e. White Sail, Basic Cruising) / Date / No. of Ashore Coaching Hours / No. of Afloat Coaching Hours

(Where necessary to meet the minimum coaching hours requirements, please list additional courses on a separate sheet)

Table 2. Relevant Personal Development or Training

Date / Description

References(Written letter(s) of reference to be included with application. Sail Canada reserves the right to verify all references and/or request additional references when required.)

School or Club Verification:

The following individual(s) can certify that the courses indicated in Table 1 above were run at the club/school indicated. In the event that no courses are indicated, I can certify that the applicant is familiar with current Sail Canada policy.

Name: ______Email: ______Club/School: ______

Name: ______Email: ______Club/School: ______

Name: ______Email: ______Club/School: ______

School or Club Reference (where applicant is not sole-operator):

The following individual has agreed to provide a professional reference.

Printed Name: ______Email: ______

Position: ______Phone: ______

Student Reference (not required if applicant is not sole-operator of school/club where courses taught):

The following individual has participated in a recent course that I have taught and has agreed to provide a reference for my teaching skills.

Printed Name: ______Email: ______

Course Taken: ______

Proclamation

I, the undersigned, hereby declare that the above information is correct. I understand that submitting this information does not guarantee recertification and that recertification decisions are at the discretion of the appropriate Committee and the Sail Canada Training Coordinator.

Signed: ______Date: ______

Payment Information / Renseignements pour le paiement:

Visa / Mastercard
Card Number / Numéro de la carte : / Expiry / Date d’expiration:
Name on card / Titulaire de la carte : / Signature:

Instructor Recertification ApplicationJuly 20101 of 2