Coaching Application

2012-2013 Coaching Application 

Name:________________________________________________________________

DOB: _____________________ SIN: _____________________________________

Address: ______________________________________________________________

Phone: (Home) ________________________ (Cell) ____________________________

　

Team Selection

First Choice: ________________________Second Choice: __________________________

If these choices are not available, would you accept a different position?

Yes _______ No ________

Proposed 1

Proposed Trainer ____________________________________________________________

Proposed Manager ___________________________________________________________

St Assistant Coach __________________________________________________

　

National Coaching Certification

Technical/Practical Certification Theory

Level 1 ( ) Year Attained _______ Level 1 ( ) Year Attained ________

Level 2 ( ) Year Attained _______ Level 2 ( ) Year Attained ________

Level 3 ( ) Year Attained _______ Level 3 ( ) Year Attained ________

　

Team/Association Category Position

　

　

2011/2012 ________________  ______________  ____________　

2010/11 ____________________ _________________ ______________

2009/10 ____________________ _________________ ______________

Please attach any additional information pertaining to this coaching application that may be applicable.

Please send completed applications to Attn:  Tina Smith, c/o PMHA, Box 85, Parrsboro NS B0M 1S0

Deadline for applications is July 6, 2012.