Please read the RCC application carefully and provide ALL details in all sections on the Application Form.

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RECOGNITION OF CURRENT COMPETENCE (RCC) APPLICATION CHECKLIST Please read the RCC application carefully and provide ALL details in all sections on the Application Form. Please check that you have correctly completed the following and tick that all items below are sent to the Coaching Department at Cycling Australia, Domain LPO, PO Box 33352, Melbourne VIC 3004 or coaching@cycling.org.au Completed Application Form (no RCC is issued without full details) Application fees payable either by cheque/money Order (payable to Cycling Australia) or MasterCard/Visa A copy of your current Cycling Australia/MTBA membership card A copy of your current First Aid Certificate A copy of your current Working with Children Check (relevant to State/Territory) A signed Cycling Australia Instructor/Coach Code of Behaviour Form Relevant documentation as evidence to support RCC application Received Office Use Only Processed Staff Signature

ROAD & TRACK SKILLS COACHING COURSE RECOGNITION OF CURRENT COMPETENCE (RC C) APPLICATION FORM Section 1: Personal Details a. Surname b. First Name/s c. Date of Birth d. CA or MTBA Membership (If you have M Ship, proceed to item j.) e. Club, School or Organisation M Ship #: Expiry Date: f. Residential Address g. Postal Address (if different from above) h. Telephone Numbers Home: Mobile Business: Fax: i. Email Address j. First Aid Certificate Certificate #: Expiry Date: k. Working with Children Check (relevant to state/territory) WCCC #: Expiry Date: Sate/Territory l. Signed Cycling Australia Coach Code of Behaviour Yes No PAYMENT INFORMATION $ 100.00 RCC Application and Administration Fee $ Cycling Australia or Mountain Bike Australia Membership VISA MasterCard Amount: Name on Card Card Number Expiry: CVV: Signature

The Cycling Australia Road and Track Skills Coaching Course (RTSCC) provides coaches with an introduction to coaching the road and track cycling disciplines including the planning, implementation, analysis and revision of such coaching sessions. This is achieved through application of the underpinning knowledge of the NCAS Accreditation General Principles Program in a manner specific to cycling. As the applicant for RCC, you will be required to provide information and evidence on your sporting background, knowledge, training and coaching experience. Your application will be assessed based on the Road and Track Skills Coaching Course Learning Outcomes. You must be able to demonstrate the following key learning outcomes: 1. Identify the roles and responsibilities of the coach, outlining the coach s ethical responsibilities while upholding their coaching philosophy. 2. Understand and demonstrate the coach in action using effective communication, group management and a game sense approach to develop skills and tactics. 3. Identify the basic road and track cycling equipment and clothing required for training and racing, along with their effect on performance. 4. Analyse a rider s equipment and position and demonstrate how to perform basic road and track bike setups. 5. Identify the key introductory Road/Track skills and tactics. Describe correct performance and demonstrate how to effectively progress each skill and tactic. 6. Establish and maintain safe and inclusive road and track coaching environments by applying appropriate risk management. 7. 8. Plan, deliver and evaluate a series of introductory road and track cycling coaching sessions that support rider development and prepare a rider for their first road and/or track club event. Demonstrate an understanding of the structure and organisation of club, state/territory and national level road and track competition in Australia including the various road and track cycling events, with awareness of both competitive and recreational events available to riders.

Section 2: Knowledge and Experience Please complete the following section in relation to your work experience, coaching, instructing, including any voluntary, unpaid, full-time or part-time work over the past 4 years. Please provide timelines (e.g. 2014) and clearly indicate which of the key learning outcomes you are addressing in this section. Experience Organisation / Employer Responsibilities Timeline KLO ** Please attached a résumé of any coaching experience and positions held. Please provide supporting evidence such as references, letters of support or reports from experienced people within the sport.

Section 3: Qualifications and Training Please indicate the education and training you have previously undertaken, including formal courses, adult education courses, professional development opportunities at work or other sport training etc. that demonstrate competency, are relevant and provide support to your Cycling Australia Road and Track Skills Coaching Course RCC application. Again, please clearly indicate which of the key learning outcomes you are addressing in this section. Qualifications/Training/PD Workshops Year Completed Length of Education/Training KLO **Please attach supporting documents e.g. certified copies of any qualifications as evidence.

Section 4: Practical Application Please list any other activities you have undertaken and/or are currently involved in that demonstrate your skills and knowledge in the key learning outcomes applicable to this RCC application. For example: hobbies, recreational, leisure or sport activities you are involved in. I declare that the evidence I have provided is a true and accurate record of my educational, work and life experiences:...... Signature of applicant Date Received Office Use Only Processed Staff Signature