Describe in detail why you want to become an MSF-certified RiderCourse RiderCoach. Use additional paper if necessary.

(This is a screening process.  What sets you apart?)

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Give a brief description of any other teaching experience.____________________________________________________

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CHARACTER

Have you ever been convicted of (including a plea of guilty or no contest) a felony, or serious misdemeanor, other than a minor traffic violation? ❏ Yes ❏ No

Are you now undergoing, or have you ever undergone treatment during the last five (5) years for the use of drugs, narcotics or excessive alcohol use? ❏ Yes ❏ No

Do you have any medical condition that requires accommodation or that would otherwise impair your ability to safely perform the duties of a RiderCoach? ❏ Yes ❏ No

If yes to any of the above, please explain fully: __________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

SPONSORSHIP

Are you being sponsored for this course? ❏ Yes ❏ No

If yes, by whom? _________________________________________________________________________________

What assistance will your sponsor provide? ________________________________________________________________________________________________

Where will you teach rider training after graduation?   Have you talked to them?  ________________________________________________________________________________________________

ACKNOWLEDGEMENTS

This application does not guarantee a position in a RiderCoach Preparation Course nor does it guarantee that the Motorcycle Safety Foundation (MSF) will issue the applicant a RiderCoach Certification. If the applicant is offered a position in a RiderCoach Preparation Course and the applicant successfully completes the RiderCoach Preparation Course, the MSF may issue a RiderCoach Certification to the applicant. A RiderCoach Certification will only be issued upon execution of a RiderCoach Certification Agreement between the applicant and the MSF. This application shall become an integral part of any RiderCoach Certification Agreement that may be executed between the applicant and the MSF. Unless and until the MSF issues a RiderCoach Certification to the applicant, the applicant is not an authorized, certified RiderCoach and may not make any representations or perform any acts as such.

I certify that I have read this RiderCourse RiderCoach Preparation Candidate Application in its entirety, and the information contained herein is true and correct and that I have not omitted any relevant information. I understand and agree that falsification of any information provided herein, or the omission of any relevant information, will result in immediate revocation of my MSF RiderCoach Certification.

Signature______________________________________________________________ Date ____________________

Requirements to become a North Carolina RiderCoach include:

a.    Licensed, experienced motorcycle operator with a minimum of 3 years licensed riding experience.

b.   High School diploma or equivalent.

c.    21 years of age minimum.

d.   Driving record with no more than 3 moving violations, no alcohol related traffic violations, and no driver’s license

     suspension, revocation, or denial within the three years preceding the date of application to become a coach.

e.    Graduate of a Motorcycle Safety Foundation Course (BRC, ERC or BRC2).

f.    Have a recommendation from a current RiderCoach.

g.   Certified in CPR.

h.   You will be expected to be a role model for North Carolina motorcyclists, and as such, will be expected to wear the

     proper gear, to include a DOT helmet, eye protection, sturdy over the ankle footwear, long pants of durable

     material, long sleeved shirt or jacket and full fingered gloves; ANYTIME that you ride a motorcycle.

Do you meet these above requirements?  ❏ Yes ❏ No If not, please explain: __________________________________

__________________________________________________________________________________________________

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Teaching a motorcycle safety course is physically demanding.  It requires long hours, walking several miles in the course of a day, bending and stooping to place cones, and sometimes the need to push inoperable motorcycles for distances up to ¼ mile.  Hot and cold weather conditions can add to the strenuous conditions you will encounter while teaching the course. 

Do you feel you are physically capable of performing this job?  ❏ Yes ❏ No

To maintain certification, RiderCoaches are required to teach a minimum of three classes a year in the N.C. Community College System, and attend an annual update training session. 

You will also be required to follow the MSF RiderCoach Rules of Professional Conduct.

You will also need to request, a copy of your driving record.  In North Carolina, this can be done through the NC DMV website.  Dependent upon the state of residence and situation, it may take several weeks to obtain the record.  Don’t delay the submission of your RiderCoach application while you wait for the driving record.  You can send the driving record at a later date or bring it to the first night of your class.  You will be required to submit a driving record every two years coinciding with your MSF recertification.

Do you agree to these conditions?  ❏ Yes ❏ No

If you are not currently certified in CPR, you must obtain this certification prior to teaching your first class.

I certify that I have read and understand the requirements to become a RiderCoach in North Carolina and that the information contained herein is true and correct and that I have not omitted any relevant information. I understand and agree that falsification of any information provided herein, or the omission of any relevant information, will result in immediate revocation of my North Carolina RiderCoach Certification.

Signature______________________________________________________________ Date ____________________

2/15

The rules of professional conduct for RiderCoaches and RiderCoach Trainers help ensure that MSF RiderCoursesSM  are conducted in a positive, efficient and professional manner. RiderCoaches and RiderCoach Trainers agree to:

1.  Conduct Rider Education Training SystemSM  (RETS) courses and training opportunities  in a manner that

      meets the standards of the MSF curricula and only at recognized Rider Education Recognition Program

     sites. RiderCoaches shall not conduct MSF training outside the US and its military installations without the

     written approval of MSF.

2.  Maintain a positive student environment.

3.  Demonstrate safe riding habits and always wear protective gear when riding to, from, and during rider

      training activities.

4.  Currently operate a motorcycle on a frequent, routine basis.

5.  Ride and drive free of alcohol and other drugs that cause impairment.

6.  Maintain a good riding and driving record.

7.  Complete RiderCoach and/or RiderCoach Trainer Professional Development as required by MSF.

8.  Inform MSF of any personal address change, maintain a current email address, and complete MSF

       RiderCoach or RiderCoach Trainer surveys promptly.

9.  Conduct one’s self in a professional manner that includes:  appropriate appearance and language; exhibiting

    positive verbal and written messages; and positive interaction with others that is free from intimidation or

        threat, consistent with MSF’s mission*.

10. RiderCoaches and RiderCoach Trainers are encouraged to support motorcycle safety programs and are not

     prohibited by MSF from speaking to the media, participating in a legislative  or legal process, or expressing

     their opinions, as private citizens and experienced training professionals.  However, RiderCoaches and

      RiderCoach Trainers shall not present themselves as speaking on behalf of MSF while taking a public

    position on safety or legislative issues or when addressing a public-policy  forum.

11. RiderCoaches and RiderCoach Trainers are free to serve as an expert witness on motorcycle safety issues

      based solely on their knowledge of motorcycling and familiarity with MSF’s curriculum.  MSF RiderCoach

        and RiderCoach Trainer certification in and of itself does not qualify a person as an expert witness.

MSF, in its sole discretion, may reject, suspend or revoke RiderCoach certification when MSF has determined that the individual has acted or has threatened to act, in connection with training or otherwise, in a manner contrary to MSF’s mission*.

I agree to abide by these Rules Of Professional Conduct.

Name (Print Clearly)                                                                  Date

Signature

*MSF Mission Statement:

To make motorcycling  safer and more enjoyable by ensuring access to lifelong quality education and training for current and prospective riders, and by advocating a safer riding environment.

Rev.3/14

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Last modified: 11/26/14