2018-2019 Warriors Midget A/AE, MD/Select Coach Application Form (North Durham Minor Hockey)
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2018-2019 Warriors Midget A/AE, MD/Select Coach Application Form
Please complete the following form to apply to coach an MD or Select team for the 2018-2019 season. Teams will be made based on registration numbers and interest.
Applicant Information
NAME
*
Enter your full name. First, middle, last
DATE SUBMITTED
*
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Select the date that this application is being submitted
ADDRESS
*
Enter your address. House/apartment number, street, PO Box
CITY/TOWN
*
Enter the City/Town where you live
POSTAL CODE
*
Enter your postal code
ADDRESS SINCE
*
How long have you lived at this address?
PHONE NUMBER
*
Example: ###-###-####
EMAIL ADDRESS
*
Example:
[email protected]
Your submission will be sent to this address.
Coaching Information
LIST THE LAST TWO (2) TEAMS YOU HAVE BEEN AFFILIATED WITH
*
Year, Team, Classification (AAA, AA, A etc), Position Held
COACHING CERTIFICATIONS
*
Coach 1 - Trained
Coach 2 - Trained
D1 - Certified
HP1 - Trained
HP1 - Certified
HTCP 1 (Trainer)
HTCP 2 (Trainer)
Respect In Sport - Activity Leader
Select what you have
HEAD COACH POSITION APPLYING FOR
*
Tyke Select
Novice
Atom
Peewee
Bantam
Midget
Check All That Apply
CLASSIFICATION
*
MD
Select
Check All That Apply
WILL YOU HAVE A CHILD ON THE TEAM YOU ARE APPLYING FOR?
*
Yes
No
WOULD YOU CONSIDER COACHING ANOTHER TEAM IF UNSUCCESSFUL WITH FIRST CHOICE?
*
Yes
No
WHAT IS THE HIGHEST LEVEL OF HOCKEY YOU HAVE PLAYED?
*
Year, Team, Level (OHA, OHL, College etc), Coaches Name
COACHING PHILOSOPHY
*
What is your philosophy on coaching Minor Hockey?
Coaching Reference #1
Enter a reference that can speak to your coaching skills and history
NAME
*
Enter your coaching references full name
TITLE
*
Title of your reference eg. Head Coach, Assistant Coach
PHONE NUMBER
*
Example: ###-###-#### x###
Coaching Reference #2
Enter a reference that can speak to your coaching skills and history
NAME
*
Enter your coaching references full name
TITLE
*
Title of your reference eg. Head Coach, Assistant Coach
PHONE NUMBER
*
Example: ###-###-#### x###
Character Reference #1
Enter a non-hockey character reference
NAME
*
References full name
OCCUPATION
*
Enter the occupation of your reference
AFFILIATION TO YOU
*
How is your reference affiliated to you? eg. Friend, brother, mentor
PHONE NUMBER
*
Example: ###-###-#### x###
Character Reference #2
Enter a non-hockey character reference
NAME
*
References full name
OCCUPATION
*
Enter the occupation of your reference
AFFILIATION TO YOU
*
How is your reference affiliated to you? eg. Friend, brother, mentor
PHONE NUMBER
*
Example: ###-###-#### x###
I agree to the terms and conditions stated above
*
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again
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Tue Feb 19, 2019
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Printed from northdurhamhockey.ca on Tuesday, February 19, 2019 at 6:03 PM
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