This form is for Pony Club Victoria 2024 Coach Members who have a coaching qualification and would like to have their details made public on the PCV website club search listing.

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Mobile Number

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* 5. Working With Children's Card Number (or equivalent)

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* 6. In a few sentences, please tell us what you believe your 'Child Safe' responsibilities as a coach, may include.

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* 7. Coaching Zones - select all that you would be willing to travel to

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* 8. Coaching Qualifications

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* 9. Preferred Disciplines - select all that apply

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* 10. Please download your qualifications as verification if you have a qualification with EA, BHS, ESI etc.  We will not be able to list your non-PCA qualifications on our website without evidence of achievement. 

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* 11. Please download your Sport Australia Safeguarding Children and Young People certificate. If this is in your JustGo, skip this step.

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* 12. Please download your Sport Australia Essential Skills Online course certificate. If this is in your JustGo profile, skip this step.

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