Blades House League Bench Staff Application (North Durham Minor Hockey)
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Blades House League Bench Staff Application
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Blades House League Bench Staff Application
Please complete the following form to request to be on a house league bench. (Coach, Trainer, Assistant Coach, Assistant Trainer)
Applicant Information
NAME
*
Enter your full name. First, middle, last
DATE SUBMITTED
*
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
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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 (If applicable)
*
Year, Team, Classification, Position Held
CERTIFICATIONS
*
Coach 1 - Trained
Coach 2 - Trained
D1-Trained
D1-Certified
HP1 - Trained
HP1 - Certified
HTCP 1 (Trainer)
HTCP 2 (Trainer)
Respect In Sport - Activity Leader
Gender Identity & Expression Course
Select what you have
POSITION APPLYING FOR
*
Coach
Trainer
Assistant Coach
Assistant Trainer
On-Ice Volunteer
Check All That Apply
DIVISION APPLYING FOR
*
Intermediate (2008-2011)
Senior (2003-2007)
Check All That Apply
WILL YOU HAVE A CHILD ON THE TEAM YOU ARE APPLYING FOR?
*
Yes
No
I agree to the terms and conditions stated above
*
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again