Coaching Application Form - 2021 - 2022

LAST NAME

FIRST NAME

Your Email Address

BEST PHONE NUMBER TO BE REACHED AT

FIRST CHOICE FOR AGE LEVEL INTERESTED IN COACHING

TIER INTERESTED IN (Mark as your FIRST choice)

NON REP TEAM (Tier 4 and below and 4 year old program)

Female

If not selected as Head Coach would you be interested as an Assistant

SECOND CHOICE FOR AGE LEVEL INTERESTED IN COACHING

Tier Interested In (Mark as your SECOND Choice)

Non Rep (Tier 4 and below)

Female

Previous Coaching Experience

Please check off the applicable coaching credentials you have.

Coach 1 - Intro to Coach (Required for Head Coach in Initiation and Novice level)

Coach 2 - Coach Level ( Required for Head Coach for anything atom and above)

Development I (Required for Head Coach for AA Team Peewee and up)

High Performance 1 (Required for Head Coach for any AAA team)

Checking Skills (Required for Head Coach for any team Atom and above)

Respect In Sport - Coach (Any person helping out on the bench)

Safety (One Team Official on the HCR Roster)

Unsure

If not qualified, can and are you able to complete the qualifications for the Head Coach position prior to November 15th of the current year?

YES

UNSURE

References if available (Please note a phone number or email address if possible)

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