OSCA APP Application Form

OSCA Advanced Performance Pathway
Date of application

Day Month Year
Essential requirments:

Full UK OSCA Membership

GOsC Registration

Registered Osteopath

Relevant supporting documentation provided

(Student/Overseas/Associate OSCA Members are not eligible for Level 1/2/3)
APP Level applying for *
Individual requirements of each level: http://www.osca.org.uk/#!advanced-pathway/c21hl
OSCA Membership Number *
Login in to find your membership number www.oscamembers.wildapricot.org
Full Name *

First Name Middle Name Last Name
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email Address *
Phone Number *

Area Code Phone Number
GOsC Registration Number
Graduation Year
Please list any special interests or experience you have in sports care:
How many years have you been qualified as an Osteopath *

1 2 3 4 5 6 7 8 9 10+
What sports-care associated CPD and further education development have you engaged in since graduating as an Osteopath (Highest level)?

PG Cert PG Dip MSc PhD Teaching/Publication N/A
Please list all relevant professional qualifications: *
*

Upload Supporting Documents

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How many hours have you spent engaged in sports care outside of your regular practice? This may include pitch-side, working as part of a medical squad, consulting, touring with teams, strength & conditioning, providing player or medical team education, other (please specify)

More than 50 hours More than 100 hours More than 150 hours More than 200 hours More than 250 hours More than 300 hours More than 350 hours More than 400 hours More than 500 hours More than 600 hours More than 700 hours

Please upload details of your sports care experience using the sample format below.

Dates	Role	Description/Further Details	Hours	Contact
eg: 2008-2011	Osteo, local rugby team (name)	Work pitchside, pre+post-match every Sat during season, and 2 hours on Tues night training = 5hrs/wee accross 1x30week season	150	Bob Smith - Team Coach 07739425687bob@gmail.com

*

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For Office Use:
Years qualified score
CPD/Education score
Hours score
Total score
Comments (eg: needs review, documentation required, rational for decision)
Should be Empty:

OSCA Advanced Performance Pathway