BGA Instructor Form 6
BRITISH GLIDING ASSOCIATION
BGA MGIR INITIAL ISSUE
Please complete the form in clear block capitals using dark ink and submit to the BGA Payment - Please use the attached payment form. Current fees are on the BGA website www.gliding.co.uk
1. APPLICANTS PERSONAL PARTICULARS

FOR OFFICIAL USE ONLY Date Received

Applicants BGA Reference Number (if known) ……………………………………………………………………….. Title………………………………………..Surname…………………………………………………………………………. Forenames………………………………………………………………….Nationality…………………………………….. Date of Birth………………………………Place of Birth……..…………………………………………………………….. Postal Address………………………………………………………………………………………………………………... ………………………………………………………………………………………………………………………………….. Post Code………………… …………Email Address………………………………………………………………………. Tel No…………………………………………….…Mobile No……………………………………………………………… Preferred contact method – email or letter? ……………………………………………………………………………… BGA Club………………………………………………………………………………………………………………………

2. MEDICAL FITNESS – NPPL MEDICAL DECLARATION OR OTHER MEDICAL STATUS CURRENTLY HELD

Please tick -

NPPL Group 1 ( ) NPPL Group 2 ( )

Instructor Form 6 BGA MGIR Initial Issue v Jul 2009

JAR Class 1 ( ) JAR Class 2 ( )

BGA Instructor Form 6 3. COURSE COACH / EXAMINER DECLARATION

I confirm that the applicant ………………………………………………………………………….(name) has completed a course of training and test and should be issued with a BGA MGIR as follows (delete as appropriate);

Group 1 Wood

Stage 1(initial) / Stage 2 (+Nav) / Stage 3 (all)

Group 2 GRP

Stage 1(initial) / Stage 2 (+Nav) / Stage 3 (all)

Group 3 Self launch

Stage 1(initial) / Stage 2 (+Nav) / Stage 3 (all)

Name………………………………………………Signature……………………………………Date……………………

4. APPLICANTS DECLARATION

I understand the privileges and limitations of the MGIR I understand the MGIR revalidation requirement in Laws and Rules I understand that additional groups and stages can be added by test with a BGA examiner I understand that additions and revalidations are recorded on an MGIR rating card by the examiner I declare that to the best of my knowledge the information on this form is accurate
Name………………………………………………Signature.………………………………………Date…………………
5. CFI DECLARATION - to be completed by the applicants BGA CFI
I confirm that the applicant holds a valid BGA Assistant or Full instructor rating. I understand the experience requirement as described in BGA Laws and Rules and hereby recommend this MGIR application.
Name………………………………………………Signature………………………………………………………………….
Date…………………………………………………BGA Reference No…………………………………………………..

Instructor Form 6 BGA MGIR Initial Issue v Jul 2009

BGA Instructor Form 6

6. PAYMENT

All fees are payable in advance with the application Cheques must be payable to ‘The British Gliding Association’
If paying by cheque, please enter the amount here £ ____________________
If paying by credit or debit card, please complete the following:

Card Holders Name (in full)
Amount in £ sterling

£

Card No

Expiry Date

__ __ / __ __

Valid From

__ __ / __ __

Card Security No. (last 3 numbers)

Address of Cardholder if different from applicant

Postcode:

Fees are detailed at www.gliding.co.uk

Instructor Form 6 BGA MGIR Initial Issue v Jul 2009