2016 SWIMMING

SWIMMING PROFESSIONAL
REGISTRATION
IS LIFE! APPLICATION FORM
Reference M3-2006

This form must be completed by each individual applying to register as a

Coach, Trainer or Instructor Member of PHILIPPINE SWIMMING INC. in
order for him/her to be affiliated with any PHILSWIM Group Member, or
that handles any instructional swimming or other form of training
program in the Philippines. Please provide all requested information.

Name
Family First Middle

Date of Birth

Month Day Year

Personal Details

Sex Marital Status Educational Attainment

Organization

Address

Home Phone

Mobile Phone

Email Address

Signature
of Applicant

Employer Name

Employer Address

Contact Person

Contact Number

Please select () the box indicating the type of Swim Club or Team you handle:

Coach-Owned Parent-Run Board School-Governed Learn-to-Swim

PHILIPPINE SWIMMING, INC.

201-B Philsports Complex | Meralco Avenue | Pasig City | Metro Manila | Philippines
Phone (632)687-7403 | Facsimile (632)687-3115 | Email office@philippineswimming.org
 2016 SWIMMING
SWIMMING PROFESSIONAL
REGISTRATION
IS LIFE! APPLICATION FORM
Reference M3-2006

MANDATORY COACH/TRAINER/INSTRUCTOR SAFETY AND EDUCATION

In order to register as a coach/trainer/instructor member of PHILIPPINE

SWIMMING INC, an individual must undergo mandatory safety and coaching
education provided by the World Swimming Coaches Association (WSCA) thru
PHILSWIM, and the Philippine Red Cross. Only teams or clubs owned by, or
employing PHILSWIM Members Coaches/Trainers and Instructors will be allowed
to register and participate in PHILSWIM activities. Swimmers handled by non-
PSI Member coaches/trainers or instructors will not be allowed to participate in
PHILSWIM activities.

ANNUAL REGISTRATION REQUIREMENTS

PHILSWIM Requirements Amount

1. Philippine Swimming Annual Registration Fee Php 800.00

2. WSCA Membership Fee Php 2,000.00

Annual Investment Php 2,800.00

ONE-TIME COACHES EDUCATION AND SAFETY REQUIRMENTS

1. PHILSWIM-Member Coaches/Trainers and Instructors are required

to continue their professional development through education.
Certification of their professional recognition and credential is issued
by the World Swimming Coaches Association (WSCA) and the
Philippine Red Cross.
2. In order for applicants to renew their annual memberships in
PHILSWIM, they should complete at least one course, and present
PHILSWIM with their certification upon renewal of membership.
3. Each swimming professional will be responsible for managing their
professional development relationship with WSCA through on-line,
home study courses, clinic attendance, enrichment courses and by
participating in mentoring/apprenticeship programs here and
abroad.

Philippine Swimming Requirements Amount

Philippine Red Cross Certification First Aid, CPR & Approximately

Lifesaving (Applicant must secure Red Cross Certification locally) Php 1,500.00

Certified Stroke Technician Certificate (for Instructors) Php 1,500.00

WSCA Level 1 Foundations of Coaching (Trainers & Coaches) Php 2,000.00

WSCA Level 2 Stroke Mechanics School (Trainers & Coaches) Php 2,500.00

WSCA Level 3 Physiology of Training (Trainers & Coaches) Php 3,000.00

WSCA Level 4 Team Administration (for Coaches) Php 3,500.00

WSCA Level 5 Leadership School (for Coaches) Php 4,000.00

Note: Philippine Swimming and WSCA will evaluate and validate other credentials and
educational training presented by swimming professionals with the possibility of credits
being awarded. Please select () the box indicating the Coaching Course you are
enrolling for: (Swimming Professionals may enroll for as many Courses per year
as desired)
PHILIPPINE SWIMMING, INC.
201-B Philsports Complex | Meralco Avenue | Pasig City | Metro Manila | Philippines
Phone (632)687-7403 | Facsimile (632)687-3115 | Email office@philippineswimming.org
 2016 SWIMMING
SWIMMING PROFESSIONAL
REGISTRATION
IS LIFE! APPLICATION FORM
Reference M3-2006

PHILSWIM Annual
Php 800.00
Registration Fee
WSCA Annual
Php 2,000.00
Registration Fee
Swim Test
(Swimming professionals must know how to swim)
TBC

MANDATORY COURSES Select at least one Cost

Certified Stroke Technician Php 1,500.00
(Mandatory for Swimming Instructors Registration)
WSCA Foundations of Coaching Php 2,000.00
(Mandatory for Year 1 Coach/Trainer Registration)
WSCA Stroke Mechanics School Php 2,500.00
(Mandatory for Year 2 Coach/Trainer Renewal)
WSCA Physiology of Training Course Php 3,000.00
(Mandatory for Year 3 Coach/Trainer Renewal)
WSCA Team Administration Course Php 3,500.00
(Mandatory for Year 4 Coach/Trainer Renewal)
WSCA Coaching Leadership Course Php 4,000.00
(Mandatory for Year 5 Coach/Trainer Renewal)
WSCA Level 1 to 5 Investment Package Php 12,000.00
(for Committed Swimming Pros and Mentor Coaches)

Total of Course(s) Selected Php.

Php. 4,800.00
Add: First-Time Registration Fee

TOTAL AMOUNT ENCLOSED Php.

APPLICATION REQUIREMENTS CHECKLIST

Requirement

1. Completed application form (no blank fields) with Coaching Course selected?

2. Payment Enclosed? If check, made payable to PHILIPPINE SWIMMING INC?

3. E-mail address and Mobile phone number of Applicant provided?

4. Photocopy of Passport?

5. Two (2) Passport-sized Photos on White Background?

6. Application Form, other certifications and credentials sent by courier?

Certification

I___________________________ certify that the information provided in this registration

application form, and all supporting documents submitted are true and correct. Further, if I
am accepted as a Swimming Professional Member of the PHILSWIM, I hereby pledge to
abide by its Rules and Regulations, and Code of Conduct.

Swimming Professionals Signature over printed name Date of Application

Please attach 2x2 recent photo with white background with your application form.

Note: Incomplete applications lacking supporting documents and payment will not be
processed. All Checks must be made payable to PHILIPPINE SWIMMING INC. and submitted
to PSI Office or deposited directly to Philippine Swimming, Inc. Bank of Commerce Account
No. 900-00-002315-0. Scan and email a copy of the deposit slip to
philswim2014@gmail.com or attach to the forms you mail or deliver to the office.

PHILIPPINE SWIMMING, INC.

201-B Philsports Complex | Meralco Avenue | Pasig City | Metro Manila | Philippines
Phone (632)687-7403 | Facsimile (632)687-3115 | Email office@philippineswimming.org