Coquitlam Minor Football Association2015 Coaching Staff Application/Registration Form

Coquitlam Minor Football Association2015 Coaching Staff Application/Registration Form

Please Complete All Applicable Fields (click field to type)

Name: / E-mail Address:
Address: / E-mail Address:
City/State: / Cell Phone:
Postal Code: / Work Phone:
Age:(optional) / Home Phone:

Applying For (click to select)

Head Coach / Manager
Assistant Coach / Any postition
Trainer

Check Program Preference & Level (click to select)

Spring Flag / Spring Flag u14 / Fall Football / Pee Wee / Midget
Spring Flag u10 / Spring Flag u16 / Flag / Jr. Bantam / No Preference
Spring Flag u12 / Spring Flag u19 / Atom / Bantam / Any Division

Do You Have Children Playing?(click to select) Yes Not Applicable

Child’s Name / Child’s Team / Date of Birth(mm/dd/yy)
Child’s Name / Child’s Team / Date of Birth(mm/dd/yy)

Coaching and/or First Aid Certification (click field to type)

Level: / Date Obtained: / NCCP #:
Level: / Date Obtained:

Coaching Experience (click field to type)

Organization / Team / Position / From Date to Date
Organization / Team / Position / From Date to Date

Playing Experience (click field to type)

Organization / Team / Position / From Date to Date
Organization / Team / Position / From Date to Date

Coaching References (click field to type)

Name / Email / Phone
Name / Email / Phone

CMFA Uniform Sizing (your usual sizing) (click field to type)

Golf Shirt / Jacket / Hat / Pant

Authorization:

I, agree to complete a Criminal Record Check from my local Police Detachment for Coquitlam Minor Football Association, and submit this document to CMFA President prior to coaching with the CMFA. I agree to read and abide by VMFL Coaches Code of Conduct and attend necessary training/meetings as a CMFA Coach. / Yes
No
Signature / Date

Please save as… your file & attach your completed/saved form to an email to

Request your CMFA Sponsor Letter for Criminal Record Check.
New Coaches are required to complete a Criminal Record check prior to coaching with CMFA. Returning Coaches must submit Criminal record check every 2 years.

Criminal Record Check may be obtained from the Police detachment of your current City of Residence (RCMP or Municipal Police). American Citizens may obtain Background Check from Police detachment within their home state.

If you feel there is additional information which is relevant, please attach the information to this application.

Mailing Address:
582 Bole Court, Coquitlam BC V3J 7L5 / CMFA Clubhouse:
Mackin Park – 1000 Nelson, Coquitlam BC