Accreditation Course Registration
COURSE DATE and ACCREDITATION LEVEL
Before registering please read the explanation and criteria under ‘ACCREDITATION’ for the appropriate accreditation level 1 or 2
Date of course you wish to attend * State / Territory * Select State QLD NSW ACT VIC TAS SA WA NT Accreditation Level * Select Level or Renewal Level 1 Level 2 Renewal of current accreditation First Name * Last Name * Street Address * Suburb * State / Territory * Select State QLD NSW ACT VIC TAS SA WA NT Post Code * Phone * Date of Birth * Male / Female * Male Female Occupation E-Mail *
YOUR MARTIAL ART AND GRADE
Principal Martial Art Discipline * Jujitsu Jiujitsu Juijitsu Jujutsu Yawara jutsu Aikido Aikido Jujitsu Brazilian Jiu Jitsu Hapkido Kenpo Jujitsu Current Grade / Rank / Belt * Date or year awarded * Person who awarded grade * School or Style in which Grade was awarded *
MEMBER / ASSOCIATE MEMBER SCHOOL DETAILS
– To attain accreditation you do need to be a member within either a Member or Associate Member School
Name of School * Head of School * School Dojo Location * Enter your schools membership number *
Membership number is beside the school name in the
CRITERIA FOR ACCREDITATION
Satisfactory completion of this course and post course activities, goes towards the requirement for NCAS Accreditation levels 1 and 2. By completing this application you confirm your understanding of the criteria and if you attend the course agree to complete all requirements for accreditation. The course fee $285.00 includes coach’s folder, tea and coffee, (lunch is not included) and NCAS Accreditation on successful completion.
Upon successful completion of accreditation, information on this form is entered onto the National Coaching Accreditation Scheme (NCAS) database of registered coaches maintained by the Australian Jujitsu Federation (AJF) as required by the Australian Sports Commission (ASC). Database information may be passed on to State Sport Education Centres and Names of accredited coaches may also be included on the AJF website. Coaches may be sent relevant up-to-date information and may be contacted by the AJF and the ASC. Your information will not be used or disclosed except in accordance with the provisions of the Privacy Act 1988.
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