Complete a separate registration form for each Instructor Candidate. x Check appropriate: o Adult Leader o Youth Age: _______

(Must be a “Complete Angler” 15 or older,) (18 or older to be a merit badge counselor.)

1. What do you hope to gain from this CAI Course?

2. I am currently skilled or a counselor for the following Merit Badges: N = need help, S = skilled (no certification), MB = Merit Badge Counselor. Fishing Fly Fishing Fish & Wildlife Management

On a scale of 1 to 5 please rate the following: (5 = excellent --- 1 = poor / N = no experience)

3. Rate your experience in using the following tackle? Cane Poll Bait Casting Spinning/Spin-casting Fly Fishing Tenkara

4. Rate your Fishing experience in the following types of waters? Inland Lakes / Ponds Small Streams Large Streams / Rivers Ocean Shore / Small Craft Ocean Large Charter Craft

What is a Certified Angling Instructor? • Fishing program advocate. • Train the Trainer position. • Fishing program resource for

your Unit, District, and Council. • Official BSA Certification. (CS 61) • Qualified for National Fishing

Staff Positions at: - Jamborees, - OA Conferences, - High Adventure Bases.

Developed and Authorized by:

Certified Angling Instructor Course Fri – Sun, Aug 25 – 27, 2017

Camp Tuckahoe 400 Tuckahoe Road, Dillsburg, PA

Share the Joy! If you enjoy fishing…

but you lack the confidence to teach what you know, sign up to become a BSA Certified Angling Instructor.

400 Tuckahoe Road Dillsburg, PA 17019

Camping Services Office Located in the Main Parking Lot:

The first building on the right after you pass Memory Lake.

Training begins at 7:00 PM

on Friday Aug 25th 2017

Overnight cabins, meals, and snacks will be available at no additional cost to participants. Family housing can be made available upon request; we have no family programs planned, but there are of opportunities to explore and enjoy in our camp.

Training Concludes with Graduation Ceremonies

at 2:00 PM on

Sunday Aug 27th 2017

Delivering Quality Fishing Programs Learn how to do it, and how to teach it:

• basic fishing and fly-fishing skills • outdoor ethics for fishing • fishing first aid and safety • cleaning and cooking • fish and wildlife habitats • how to make it “Make it Fun!”

Who Should Attend?

Anyone wanting to provide a stronger fishing program for youth in their area, including: • Unit Leaders: o Cub Scout, Boy Scout and Venture

• Merit Badge Counselors • Day Camp & Resident Camp Staff

You Should Attend!

Please detach this section of the flyer and submit it with payment to:

New Birth of Freedom Council, One Baden Powell Lane Mechanicsburg, PA 17050

Or register online at nbf.tentaroo.com

Name:_______________________

Unit (Type & Number): ____________

e-mail:___________________

Home Phone:_______________

Cell Phone: ________________

City:_______________________

State: ________ Zip__________

Payment Amount $75.00

Check #_____________________

or:

Credit card Type:______________

Number:_____________________

Expires: _____________________

____________________________ Signature and Date

Note: Registrations will be limited to the first 24 paid applications received; further applications will be held in reserve.

Cancelations are non-refundable, 30 days or less prior to the event. Pre-registration fees will be used to purchase course materials.