Trial Day Coach Application Form

Please use this form to express your interest in working with Pro11 at our trial days.

Full Name (First Name & Surname) *

Title (Mr/Mrs/Miss/Dr etc)

Date of Birth *

Address *

Email *

Contact Telephone Number *

Please tell us about your coaching experience, e.g. length of time coaching, age groups worked with, any areas of specialism, any professional organisations you have worked with *

Please tell us what relevant qualifications you have, e.g. Level 1, Level 2, UEFA A,B etc *

What other additional qualifications / certifications do you have? *

First Aid Certificate
DBS Certificate
Scouting / Talent ID Qualifications or Experience

Do you have Sports Coach Insurance / Public Liability Insurance? *

Yes
No
Not at present but can be arranged

Pro11 operate trials in 6 locations and are looking to expand to other areas in the near future. Are you willing to travel to trial locations other than near to where you live? (Saying no will not affect your application) *

Yes
No
Not sure

Please upload any documents in support of your application e.g. coaching certificate, DBS certificate, Insurance Certificate (optional at this time, but will be needed before commencing work with Pro11)

Click or drag files to this area to upload. You can upload up to 5 files.

Anything else you would like to add in support of your application.