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Club & Athlete Mentor - Wrestling Indonesia PB PGSI
1. Identity Data
ID Number
Will be generated automatically if left blank.
Full Name & Degree
*
Place of Birth
Date of Birth
NIK Number (National ID)
*
Required 16 digits for official identity verification by PB PGSI.
Membership Card Number (KTA)
(Optional)
Optional. Official membership card number from PB PGSI / Club (can be left blank).
Origin / Region (Prov / Club)
*
License Level
*
-- Select License Level --
1. Pelatih Klub
2. Pelatih Daerah
3. Pelatih Nasional
4. Pelatih Internasional
2. Track Record & Experience
Athlete Track Record (Past competitive achievements)
Coaching Record (Clubs coached, athletes & achievements)
3. Upload Documents & Photo
Upload Profile Photo (JPG, PNG, WEBP)
JPG, PNG, WEBP (Maks 5MB).
Upload National ID / Identity Card (PDF, JPG, PNG)
Maximum file size: 10MB.
Upload License Certificate (PDF, JPG, PNG)
Maximum file size: 10MB.
4. Login Account & Contact
Active Email Address
*
Active WhatsApp Number
*
Password
*
Confirm Password
*
I declare that the submitted information is true and accurate.
Register as Coach