Level 2 PI Classifier Programme (Tunis)
World Para Athletics would like to thank you for your interest in participating in our education
programmes. Please submit the below fully completed form including any necessary
attachments to IPC Summer Sports Education Co-ordinator. Before filling in the form, please
carefully read the below programme details:
Programme dates:
Arrival date:
06 April 2017
Theory session:
07 – 09 April 2017
Departure date:
10 April 2017
Programme language:
English
Participants funded by Agitos Foundation
•
Applicants from Tunisia, Algeria, Sudan,
•
•
For applicants from other countries than
Libya, Ethiopia, Morocco, Egypt and
those mentioned on the left-hand side a
Somalia are eligible for a full scholarship
participant fee of 270 EUR will apply.
from our funding partner.
•
Self-funded participants
•
After selection to the programme the
For those applicants the funding partner
candidate will be sent an invoice for the
will cover the participant fee, transport,
participant fee and a voucher code for the
accommodation and meals.
Level 1 Classification Course (online). Once
It is your responsibility to arrange any
the participant fee is paid for the
insurance that you may need (e.g.
participant has confirmed his attendance
travel/medical, liability).
and cannot be refunded.
•
It will be your responsibility to arrange
accommodation (full board), and transport.
World Para Athletics will support with an
accommodation package (price tbc) upon
request.
•
It is your responsibility to arrange any
insurance that you may need (e.g.
travel/medical, liability).
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Candidate profile for the programme:
Candidates must have:
• completed the Level 1 Classifier Programme before start of this programme
• Athletics specific knowledge and interest in Para athletics
• the desire to serve as a National PI Classifier in current country of residence
• competency in the English language
Candidates preferably should also have one of the following backgrounds:
• a certified health professional which World Para Athletics at its sole discretion deems
acceptable, e.g. physicians and physiotherapists
• extensive coaching or other relevant background in the sport of World Para Athletics, or
a recognised and reputable academic qualification which encompasses a requisite level
of anatomical, biomechanical and sport-specific expertise, which World Para Athletics at
its sole discretion deems to be acceptable
Please write down your details:
Programme code:
AT2CL TUN
Last name:
First name:
Gender:
Nationality:
Date of Birth:
Full address:
(street, city, ZIP code, country)
Email address:
Mobile phone number:
What is your native language?
Are you fluent in English?
No
Yes
What is your profession?
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What are your qualifications
(e.g. university degree, professional
certifications)?
Do you have the support of your NPC
to participate in this programme?
No
Yes
If yes, which is your NPC?
If yes, NPC contact person name:
If yes, NPC contact person email:
Documents attached to this form:
Any certificates proving qualification as outlined
in candidate profile above (e.g. medical
certificate, coaching certificates)
Any other relevant certificates (e.g. previous
Classification programmes attended)
If you have experience as a PI Classifier, please list your experience below (e.g.
competitions officiated at, type and number of athletes classified):
If you have any experience with para sport in other roles than Technical Official or
Classifier for Athletics, please provide a brief description below (e.g. para sport coach,
team official, Classifier for another sport than Athletics):
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National Paralympic Committee (NPC) / National Athletics Federation (NF) affiliation:
I confirm that I do not hold a paid or volunteer position in a NPC / NF or national team. Or
I acknowledge my affiliation to a NPC / NF or national team. Please specify:
Signature of the applicant: ___________________________________________________
Below only to be filled out by applicants who are in touch with their NPC / NF:
Name of the NPC / NF:
___________________________________________________
NPC / NF signature:
___________________________________________________
NPC / NF stamp:
Invoicing instructions for participant fee (if applicable and if different from contact details
above):
Name/Organisation:
Full address:
(street, city, ZIP code, country)
Email:
Please return your application form no later than 8 March 2017 to:
By email:
[email protected]
By fax:
+49 228 2097 209
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