VETERINARY COURSE DIRECTOR - APPLICATION FORM

Application for Nomination as Veterinary Course Director

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Application for presenting
Testing Veterinarian Courses / 1-day course
General Veterinarian Courses / 2-day course
Advanced Courses for Endurance Official Veterinarians / 1-day course
Courses for Endurance Veterinary Treatment Officials / 1-day course
Personal Details
Name and surname
Date of birth
Email address
Mobile number
Home address
Nearest international airport(s)
Distance from home to nearest international airport(s)
Nationality
Passport number
Passport issued on
Passport expiring on
Frequent flyer programme and No.
Please mention any visa you already possess and its validity
Availability
Please indicate your average
email response time
Will you be available for a 30-minute Skype interview at the end of January 2017? / Yes No
Will you be available for consultation or creation of new course contents in February-March 2017? / Yes No
Will you be available for a 2-3 day course directors’ meeting in May 2017 (covered by the FEI)? / Yes No
Please mention the maximum number of days you could travel for the FEI in 2017 (please count
3 days for 1-day courses and
4 days for 2-day courses) / days
Cover Letter – Why would you like to be a Course Director?
Language & Communication Skills
Are you fluent in English (spoken and written) / Yes No
Do you speak otherlanguages?
What do you perceive as your strengths with regards to communication and interpersonal skills?
What do you perceive as your weaknesses with regards to communication and interpersonal skills?
IT Skills
Are you conversant with MS Office, in particular with PowerPoint and Excel? / Yes No
Are you conversant with file storing and sharing websites (Dropbox, WeTransfer, etc.)? / Yes No
What model of laptop will you use for the courses?
What media player(s) is installed on your laptop?
Academic Qualifications
Please list your veterinary academic qualifications and the year in which you obtained them
Please list yourfields of expertise and/or interest
Please list your major publications (articles, scientific papers, books, etc.) and the year in which you published them
Clinical Experience
Are you currently working within equine clinical practice? If so, please describe your role / Yes No
If not currently in practice, please outline your previous experience
Overseas Experience
Please mention any overseas veterinary experience you may have had
Teaching Experience
Have you taught on an academic level? If so, please give details / Yes No
Have you already been an FEI veterinary course director? If so, please mention the number of courses you gave during the last
2 years / Yes No
Have you presented at veterinary conferences or seminars? If so, please give details (most recent ones) / Yes No
Have you been involved with national training programmes within your NF? If so, please give details / Yes No
Have you mentored candidate OVs, EOVs or EVTs during the past 2 years? If so, please give type and number of candidates / Yes No
Have you supervised the training of testing veterinarians or technicians during the past 2 years? If so, please give details / Yes No
What do you perceive as your strengths with regards to teaching?
What do you perceive as your weaknesses with regards to teaching?
FEI Experience
FEI ID number
FEI Veterinarian since
Official Veterinarian / Jumping
Driving / Dressage
Reining / Eventing
Vaulting
Endurance Official Veterinarian / 2*EOV / 3*EOV / 4*EOV
Endurance Veterinary Treating Official / 2*EVT / 3*EVT / 4*EVT
Testing Veterinarian / Yes No
Since
Are you abreast ofthe latest versions of the Veterinary, Anti-Doping and General Regulations? / Yes No
Are you at ease with the electronic veterinary report? Please mention the last one you filled in / Yes No
Are you at ease with the electronic testing report? Please mention the last one you filled in / Yes No
Please describe your experience with testing at FEI events?
Please give a summary of your 2016 activity (officiating, treating, testing)
What is the highest level of events you officiated at and what was your role?
Have you faced any particularly difficult situations when on duty for the FEI (fatality, infectious disease, conflict of interest, conflict with other officials, etc.)? Please give a few examples
Do you hold any other FEI role (steward, judge, etc.)? / Yes No
Have you competed on FEI level? / Yes No
Other Experience
Do you have any other non-veterinary experience that may be valuable to your role as course director?
Comments
Please share any additional comment or concern you may have

National Federation’s Approval

NF
Name
Date / Stamp and Signature

1