USTA/Disabled Sports USA Wheelchair Tennis Coach Development Workshop

USTA Wheelchair Tennis Training Workshop Registration

Dear applicant,

Thank you for registering for our Wheelchair Tennis Coach Development Workshop. With support from the Department of Veterans Affairs, Disabled Sports USA is partnering with USTA National Wheelchair Tennis Staff to offer training at no cost for tennis instructors, VA staff, DSUSA Chapters and other sport providers who serve disabled veterans (at no cost to the veterans) to give tennis instruction to wheelchair tennis players. Eligible participants can apply for an equipment grant to acquire sport chairs for their program and receive USPTA Wheelchair Tennis Certification at no cost through this course.

Three workshops will be held in total:

1. USTA National Campus, Orlando Fl. February 13-14

2. The Westwood Club, Richmond, VA April 4-5

3. Main Adaptive Sports and Rec, New Gloucester, ME May 19-21

Upon registering, you will receive a fact sheet with an agenda.

People in attendance will also receive continuing education credits.

Should you need any help or have an inquiry, please contact Jason Allen at 407-718-6343 or email at jason.allen@usta.com.

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* 1. Please fill in your contact information.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. For which workshop are you registering?

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* 3. What is your tennis experience?

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* 4. Please choose your gender.

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* 5. Please choose your ethnicity.

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* 6. For what organization do you work and what is your title?

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* 7. Are you staff or volunteer?

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* 8. Check all that apply.

I am a veteran

I am a disabled veteran

I am a disabled member of the armed services.

I am a VA staff member

I am a Disabled Sports USA chapter member

I provide sports and recreational services to disabled veterans free of charge

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* 9. Is this your first time attending a training sponsored by Disabled Sports USA's Adapt2Achieve program?

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* 10. Please describe accommodations you may need to participate fully in the training due to disability, injury, or other medical condition.

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* 11. Are you a USPTA certified tennis professional and if so do you want to obtain wheelchair tennis certification?

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* 12. USPTA Certified Professionals are eligible to receive a scholarship to obtain wheelchair tennis certification. Please provide a statement for why you are pursuing the training/certification and how it will be of benefit to the disabled veterans in your community.

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* 1. Please fill in your contact information.

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* 2. For which workshop are you registering?

Question Title

* 3. What is your tennis experience?

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* 4. Please choose your gender.

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* 5. Please choose your ethnicity.

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* 6. For what organization do you work and what is your title?

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* 7. Are you staff or volunteer?

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* 8. Check all that apply.

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* 9. Is this your first time attending a training sponsored by Disabled Sports USA's Adapt2Achieve program?

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* 10. Please describe accommodations you may need to participate fully in the training due to disability, injury, or other medical condition.

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* 11. Are you a USPTA certified tennis professional and if so do you want to obtain wheelchair tennis certification?

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* 12. USPTA Certified Professionals are eligible to receive a scholarship to obtain wheelchair tennis certification. Please provide a statement for why you are pursuing the training/certification and how it will be of benefit to the disabled veterans in your community.

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* 13. Do you wish to obtain CEU's? Select all that apply.