INSTRUCTIONS FOR FILLING OUT REQUEST FOR A CERTIFICATE

Please use one form for each club. Fill out the request form following the numbers on the form. Examples of Request for a Certificates are included on the following pages.

This form is a "Template Form". Just click on the "Date Box" in the gray area and start typing the appropriate information. Use the Tab key to go from box to box. If you need Help, press the Fl key and a Help box will pop-up. For the Facility and the Additional Insured boxes, the information will automatically wrap around when it exceeds the width of the page.

1.      Type in date.

2.      Type your Affiliate name - DO NOT use abbreviations.

3.      Type your name, address, and telephone number.

4.      Type Club or Affiliate name - DO NOT use abbreviations.

5.      Type club's address - this is optional and for your information.

6.      Type Number of Members - from roster that accompanies this form. Only used on initial enrollment. Leave blank for remaining requests.

7.      Type Facility Name and list all rooms used in parenthesis - DO NOT use abbreviations.

Fill in complete address.

8.      Type Day of the week - use Monday, Tuesday, etc. unless it is a one-time weekend festival, progressive squares, street dance, parade, or a one-day event, then use the calendar date (May 6, July 10, etc.)

9.      Type Name of Additional Insured - only if required by facility being used. Get wording from facility owner and include address. Do not add additional insured unless the facility is requesting it. It only adds to the time it takes to receive the certificate back.

10.  Check the "Endorsement Required" box if the facility is requesting an endorsement.

11.  For the next facility, follow Items 7 through 10 above. For Training purposes, this form

only shows room for two facilities; actual form has room for three.

You must send in three copies of the form by mail for Initial Enrollment. Once Initial Enrollment for the Club has been completed, you can send in additional requests by attaching this form to an email. Keep one copy for your records.

Any request not in this format will be sent back for correction.

 

August 2008