Blades House League Bench Staff Application (North Durham Minor Hockey)

Print 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

DATE SUBMITTED^*

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^*
CoachTrainerAssistant CoachAssistant TrainerOn-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?^*
YesNo