
STEVEN A. McCALEB
103 ALVERADO DRIVE
LONG BEACH, MISSISSIPPI 39560
PHONE & FAX: (228)-868-8428
Mrs. Betty Long
Safety
Please provide me with Mr. John Toner's, recent and past, " MOTORCYCLE INSTRUCTOR COURSE CANDIDATE APPLICATIONS," as shown below.
I am making this request under the, "Freedom of Information Act," in which you have 20 days to provide requested records.
You can also view this request on my web page: http://mississippiwebsite.com/navalmotorcyclequal.htm
Sincerely,
Steven A. McCaleb
www.mississippiwebsite.com/seabeebase.htm
Naval Safety Center Sponsored Motorcycle Instructor Courses |
|
To ensure adequate qualified instructors are available to conduct command traffic safety training as required by OPNAVINST 5100.12G and MCO 5100.19D, the Naval Safety Center conducts train-the-trainer courses. Sponsoring commands are encouraged to review their current instructor's for certification expiration dates and prospective losses. (Initial instructor certification period is 3 years with refresher training required every 3 years thereafter). New sponsors or prospective instructors may contact the NAVSAFECEN phone number below to obtain more information on train-the-trainer courses. The following NAVSAFECEN instructor qualification requirements apply to those individuals teaching the Motorcycle Safety Foundation's Motorcycle Rider Course, Riding and Street Skills or the Experienced Rider Course:
For quota information, write Commander, Naval Safety Center (Code 42), 375 A St., Norfolk, VA 23511- 4399 or call DSN 564-3520, Ext 7135; COML (757) 444-3520, Ext 7135. Submit an instructor candidate application to the above address. |
1. NAME:
BIRTH DATE:
HOME ADDRESS:
CITY/STATE/ZIP:
HOME PHONE:
( )
EMAIL ADDRESS
2. MILITARY
If active military or DoD civilian complete the
following:
RANK, RATE OR GRADE: MIL CIV
DUTY STATION:
(Do not abbreviate name of command)
CODE
OR DIVISION:
PROJECTED ROTATION DATE
PHONE: DSN
COML ( )
FAX
3. EDUCATIONAL BACKGROUND
HIGH SCHOOL GRADUATE OR GED?
YES NO
COLLEGE/UNIVERSITY GRADUATE?
YES NO
DEGREE AND MAJOR FIELD OF STUDY:
List other educational institutions you have
attended or any specialized
training you have received. Identify
any
certificates
or advanced degrees.
Teaching experience:
YES NO
If
yes explain:
Enclosure
(3)
4. MOTORCYCLE OPERATORS LICENSE #
STATE
How many years have you had a motorcycle license
or
endorsement?
Has your operator license ever been revoked or
suspended?
YES NO
If
yes: When Where
Why?
5. Are you currently operating a motorcycle?
YES NO
How many years have you been operating a
motorcycle?
What type of motorcycle do you own? MAKE
MODEL
How many miles did you ride last year?
What types of riding?
Commuting
Touring
Recreational
Off-Road
Have you been involved in competitive motorcycle
racing?
YES
NO
Type: Motorcross Enduro
Flat
track Trials
Road Other
6. Have you completed the Motorcycle Rider Course:Riding and
Street Skills (MRC:RSS)? YES
NO
ERC? YES NO
If yes: When?
Where?
7. Have you attended any other motorcycle safety course?
YES
NO
If
yes, please identify each course and give
a brief description:
8. Describe in detail why you want to be a MSF certified
Instructor. Use additional
paper if necessary.
2
9. Give a brief description of any other teaching experience.
10.
Will you be able to teach rider education courses upon
certification? YES NO
If yes, when and where?
11.
Do you have any medical condition which would require that we
make
an accommodation in this course? YES
NO
If yes, please describe.
Signature:
Date:
This application does not guarantee a
position in a course.
Certification is based on a satisfactory driving record.
Complete the attached form if not providing a current copy of your
state's driver license record.
Enrollment in a Motorcycle Instructor Course does not guarantee
certification. Instructors that do
not teach in the first year may lose their certification.
For further information contact Code 424:
Phone:
DSN 564-3520 Ext 7135
COML
(757) 444-3520 Ext 7135
FAX
(757) 444-6044 DSN 564-6044
EMAIL
WCOSBY@SAFECEN.NAVY.MIL
Commander
Naval
Safety Center (Code 424)
375
A Street
Norfolk VA 23511-4399
STEVEN
A. McCALEB
www.mississippiwebsite.com