2019-20 Travel Coach Application (Riverside Minor Hockey)
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2019-20 Travel Coach Application
Please ensure that *all* sections of the form are completed. DEADLINE FOR SUBMISSION IS MARCH 8, 2019
Personal Information
Provide Full Name and address
*
Please provide your email address:
*
Example:
[email protected]
Phone Number:
*
Example: ###-###-####
Coaching History
Provide as much background as possible on your personal hockey coaching experience.
Please provide a detailed history of your Coaching background
*
(Include teams you have coached, location and year in which you coached).
Please provide 2 references (include their contact information) and if possible include one from a former player that you have coached in the past. If you are unable to provide references please explain.
*
(NOTE: if providing a reference of a player he/she must be older than 15yrs of age)
Please outline your goals and objectives for a team you would be coaching:
*
Do you have a valid police clearance (less than 3yrs old) that includes coverage for the Vulnerable Sector?
*
Yes
No
If you answered NO to the above question, are you willing to undergo screening for a Police Record Check?
Yes
No
Do you have current coaching certification credentials? If so please provide details.
*
Team Request
What team is your first choice for consideration?
*
Select One...
Novice Major (2011)
Atom MINOR (2010)
Atom MAJOR (2009)
Peewee MINOR (2008)
Peewee MAJOR (2007)
Bantam MINOR (2006)
Bantam MAJOR (2005)
Midget MINOR (2004)
Midget MAJOR (2003/02)
Juvenile
Do you have a SECOND choice for consideration to coach?
(Not required)
Do you have a player that is a son / daughter / relative on the team(s) you are applying for?
*
Yes
No
If you answered YES to the above question please provide details of the relationship as well as the name of the player.
Please provide information on your intended coaching staff if available
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 riversideminorhockey.ca on Tuesday, February 19, 2019 at 8:44 AM
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