23-24 Coach Application - REP (Belleville Minor Hockey Association)
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23-24 Coach Application - REP
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23-24 Coach Application - REP
Applicant Information
Please fill out all the information below.
Name
*
Home Address
*
City
*
Postal Code
*
Home Phone
*
Example: ###-###-####
Business or Mobile Phone
Example: ###-###-####
Email
*
Example:
[email protected]
Date of Birth
*
Team Information
Please indicate which teams you are interested in coaching from the drop down list below.
Team Preference #1
*
Select One...
U9
U10AA
U10A
U11AA
U11A
U12AA
U12A
U13AA
U13A
U14AA
U14A
U15AA
U15A
U16AA
U16A
U18AA
U18A
Will You Have Child On This Team?
*
Yes
No
Team Preference #2
If your child doesn't make your team preference selected above - would you be willing to coach the team they do play for?
*
Select One...
Yes
No
Coaching Experience
Please provide a detailed background of your coaching experience.
Have you coached in Belleville in the past 5 years?
*
Yes
No
What Teams
What Level of NCCP Certification Do You Currently Hold?
*
Coach Stream / Intro CoachIntro
Development 1
Development 2
High performance 1
High performance 2
Trainer level 1
Trainer Level 2
Check All That Apply
Coaching Certificate Expiry Year
What makes you the ideal coaching candidate?
What is your coaching philosophy?
This is you chance to add any additional comments you would like the coach selection committee know about you
Have you completed the Gender Identity and Expression Course
https://www.omha.net/coach
References
*** Only Required if Applying to Coach a Select Team, If you are applying for a HL Team only, you may leave this section blank. *** In order to better evaluate coaching candidates at the Select level, we require a reference for every Select Team Coach applicant. The below information is mandatory for your application to be considered for a Select Team. These are professional references only and cannot be from a family member.
Reference 1 Name
Reference 1 Daytime Phone Number
Example: ###-###-####
Reference Letter 1
Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
Maximum # Files: 1. Maximum File Size: 4MB.
Please upload a reference letter in .doc or .pdf format
Additional Requirements
Do you have PRS / RIS Activity Leader Certification?
*
Yes
No
Have you had a Criminal Records Check (including a Vulnerable Sector Search) done in the past 2 years?
*
Yes
No
If selected for an interview, you are required to bring a copy of the Records Check / VSS with you to the interview.
Year of Police Check
*
Select One...
2023
2022
2021
2020
2019
None Current - Will Apply Today
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again