Paddle Alberta Instructor Membership Application

* First Name:
* Last Name:
* Address:
* City:
* Province:
* Postal Code:
* Phone:	( )
Fax:	( )
* Email:
* Gender	Male Female

Instructor Type (please check all that apply)

PC = Paddle Canada:

Paddle Alberta Waterfront Canoe Instructor	PC Instructor Certification(s):
Paddle Alberta Basic River Tandem
Paddle Alberta Basic River Tandem/Solo
Paddle Alberta River Tripping Leader

Instructor Trainer Designations (please list):

Paddle Alberta Instructor Membership Fees:

3 year Membership $60
1 Year Membership $30
You must have a Current Paddle Alberta Instructor Membership to teach both Paddle Alberta and/or Paddle Canada courses in Alberta.

Keep up to date on recreational paddling in Alberta and Canada.
Paddle Alberta Instructor Members are eligible for one Instructor Certification Upgrade Subsidy per year. Please contact Paddle Alberta for current policy details or refer to website.
Financial assistance is available to Paddle Alberta Member Clubs/Organizations through Paddle Alberta Matching Funds Program for equipment purchases, building development and Instructor Certification Development.
Participate in environmental and safety issues and programs affecting our paddling environment.
Networking opportunities with other Instructors and clubs and organizations across the province.
Instructor Website that keeps you informed of employment opportunities, Instructors –For-Hire list, changes to certification programs and upcoming courses and recertification clinics.

Volunteer Opportunities:

Executive positions (President, Vice-President, Secretary, Treasurer, Education Chair, Safety Chair and Environmental Chair)
Participate in Education and Environmental Committees.

Privacy Statement:

Respecting your privacy is important to us and we will not divulge your personal information to outside parties without your permission. Please contact us at 1-877-388-2722 or Email if you have any questions regarding your personal information or its use.

Your membership information is for Paddle Alberta /CRCA use only. However, many groups and individuals across the province contact Paddle Alberta to find instructors in their area. Please indicate below whether or not you will allow Paddle Alberta to distribute your contact information.

Do you wish us to distribute any of your personal information to groups looking for instructors?
YES
NO

If yes, please indicate which contact information:
Same as above

Address:
City:
Province:
Postal Code:
Phone:	( )
Fax:	( )
Email: