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Application Form - IPCH Courses for Officials
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General Information
Name and Surname of the candidate
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Date of birth of the candidate
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Place of birth of the candidate
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Email of the candidate
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Address of the candidate
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Country
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Name of the World Ability Sport Member Organization supporting the application
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Contact Person of the World Ability Sport Member Organization supporting the application
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Which course are you applying
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IPCH CLASSIFIERS COURSE - 17 – 21 April 2024 Section
Which of the following requirements does the candidate have?
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Please give more information about the candidates background and experiences according to the previous question.
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Please give more information about the motivations and reasons the candidate has decided to apply to this course
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Has the candidate:
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Has the candidate ever seen or partiticipated in a Powerchair Hockey competition?
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Is the candidate active on a National level in this role?
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IPCH REFEREE OBSERVERS COURSE - 18 – 21 April 2024
Which of the following requirements does the candidate have?
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Please give more information about the candidates background and experiences according to the previous question.
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Please give more information about the motivations and reasons the candidate has decided to apply to this course
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Has the candidate:
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Is the candidate active in the national Powerchair Hockey organization / league?
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If yes in what role?
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Practical Information
Does the candidate use a wheelchair or other mobility aids?
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If yes, please specify the type of mobility aid used (ex. manual wheelchair, electric wheelchair etc)
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Does the candidate need wheelchair friendly room?
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Only for candidates with disability -
Will the candidate be accompanied by a Personal Assistant?
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If yes please indicate the following data about the PA
Name and Surname
Address
Country
Date and place of birth
plase add in the next questions about diets and general needs also the need of the PA
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Does the candidate need High low bed? (LOC can ask for renting costs)
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Are there diet restrictions the LOC should be aware of:
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Are there special need or request for the LOC?
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T shirt size of the candidates
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THANK YOU FOR YOUR APPLICATION
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