Portsmouth Olympic Harbour 53 Yonge Street, Kingston, ON, K7M 6G4 For National, Senior National and course conductor level certification, return form to: Official Certification Committee C/o Canadian Yachting Association Portsmouth Olympic Harbour 53 Yonge Street, Kingston, ON, K7M 6G4 fax – (613) 545-3045 e-mail – sailcanada@sailing.ca For Assistant & Club level certification, return form to: Your Provincial Sailing Association http://www.sailing.ca/organizations/provincial/

Name of Host Club and Regatta Chair RACE MANAGEMENT EXPERIENCE Please list the event(s) and year(s) at which you served as a ARO, CRO, NRO or SNRO. Year Regatta Name Classes Sailed Name of Host Club and Regatta Chair Your Role # of Races started

Course Conductor and Guest Speakers RACE MANAGEMENT TRAINING SEMINARS Please list the event(s) and year(s) at which you attended training seminars. Date Seminar Name Course Conductor and Guest Speakers Host Club An email addresses of all National and higher officials (ROs, Judges & Umpires) who have served with you in the previous 4 years. Email Address Event Name

Please ensure that you meet and check off all the applicable requirements. Signature Date