BGA Instructor Form 4
BRITISH GLIDING ASSOCIATION

FOR OFFICIAL USE ONLY

BGA ASISTANT INSTRUCTOR RATING POST INSTRUCTOR COURSE REVIEW / COMPLETION COURSE NOTIFICATION
Please complete the form in clear block capitals using dark ink and submit to the BGA
There is no payment required with this application.
1. APPLICANT’S PERSONAL PARTICULARS

Date Received

Applicant’s 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 ( ) EASA/JAR Class 1 ( ) EASA/JAR Class 2 ( ) LAPL ( )
Instructor Form 4 BGA Post Instructor Course Review v May 15

BGA Instructor Form 4 4. POST COURSE REVIEW / COMPLETION COURSE RECORD & COACH DECLARATION Place of post course review…………………………………………………………….Date…………………………… I certify that…………………………………………………………………has completed the BGA post instructor course review to my satisfaction. Course Coach Name………………………………………………Signature……………………………………………. 7. APPLICANT’S DECLARATION I certify that the particulars on this form are correct to the best of my knowledge and belief. I understand the privileges and limitations of the rating and my personal responsibilities including medical fitness and currency. Signed……………………………….Surname…………………………………….…………Date……………………….
Instructor Form 4 BGA Post Instructor Course Review v May 15