Cads Level 1 Certification Course

CADS LEVEL 1 CERTIFICATION COURSE

APPLICATION FORM

Course Location: Division: BCAS Dates: Applicant Name: Date of Birth://

Day/ Month/ Year

Address 1: Address 2: City:

Province: Country: Postal Code:

Primary Phone: 2nd Phone E-Mail

Membership Number:

PRE-REQUISITES: (To be completed by applicant and verified by course conductor/ examiner)

1.  Current CADS membership (P) Yes No

2.  Completed CSIA/CASI Teaching Methodology (6 hour clinic) Area received

Date received //

Day/ Month/ Year

Instructor

Signature

OR CASI/ CSIA Certification: CSIA # CSIA Level / CASI # CASI Level

I agree the above information is accurate and true. Applicant initials here:

APPLICANT SIGNATURE: Date: //

COURSE REQUIREMENTS: (This section to be completed by course conductor/ examiner)

1.  Completed 8 Hour Level 1 CADS Clinic – Adaptive Area received

Snowsports Methodology Date received //

Day/ Month/ Year

Instructor

Signature

2.  Passed Open Book Exam (1 hour time limit) Area received

Date received //

Day/ Month/ Year

Examiner

Signature

LEVEL 1 CADS COMPLETED: YES NO Examiner Signature: Date //

Day/ Month/ Year

PLEASE NOTE; Completed application form and applicable course fees must be received by course organizer at least 14 days before course date.

December 2013