VA Adaptive Coach Education Grant Application for Virtual Symposium

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* 1. Coach/Instructor Information

Full name of Coach/Instructor Applying

Email address

Phone number

City

State

USA Archery Membership Number

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* 2. Please list the archery programs you are involved in that work with Active Duty or Disabled Veterans:

Club/Program

Club/Program

Club/Program

Club/Program

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* 3. Please list the NAME AND ZIP CODE of the Active Duty or Disabled Veterans you are currently coaching(failure to provide this could prevent you from applying for this grant):

Athlete and Zip Code

Athlete and Zip Code

Athlete and Zip Code

Athlete and Zip Code

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* 4. Please list select the grant you are applying for?

VA Adaptive Coach Grant for USA Virtual Symposium

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* 5. How many coaching sessions per week do you currently work with current disabled active duty military or disabled veterans?

1 or less per week

2-4 per week

5-7 per week

More than 7 per week

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* 6. By selecting "I agree" you acknowledge and confirm that the information presented in this grant application is true and accurate.