2021- 2022 House League Coach Application (Whitby Minor Hockey)
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2021- 2022 House League Coach Application
General Information
First Name:
*
Last Name:
*
Primary Contact Number:
*
Email Address
*
Coaching Information
Please indicate what division you are interested in coaching this season.
Division
U5 (2017)
U7 (2016)
U7 (2015)
U8 (2014)
U9 (2013)
U10 (2012)
U11 (2011)
U12 (2010)
U13 (2009)
U14 (2008)
U15 (2007)
U16 (2006)
U21 (2005-2003)
Check All That Apply
Do you have a child playing in this division(s):
*
Yes
No (Non-parent coach)
If yes, players name(s):
Do you have a Trainer request? Please note that only ONE coach request will be accepted.
*
Yes
No
If yes, please provide bench staff request?
First/Last Name - Joe Smith
Certification & Qualifications
Certification level:
*
No Certification
Coach 1 - Intro to Coach - Trained
Coach 2 - Coach Level Trained
Development 1 - Trained/Certified
HTCP Level 1 - Trainer
Check All That Apply
Have you completed the Respect in Sport Activity Leader Course?
*
Yes
No
Unsure
If you select Unsure WMHA will contact you to verify.
To the best of my knowledge, WMHA has a VALID Vulnerable Sector check on file
*
Yes
No
Unsure
If you select Unsure WMHA will contact you to verify.
Coaching Experience
1. Organization:
Team:
Position:
Season(s):
2. Organization:
Team(s):
Position:
Season(s):
References
Reference #1 - Name:
*
First name/ Last Name
Phone Number:
*
905-444-9642 format
Reference #2 - Name:
*
First name/Last Name
Phone Number:
*
905-444-9642 format
Comments
Please include any additional comments or questions.
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again
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Thu Jun 30, 2022
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