NORMAN REGIONAL MINOR HOCKEY ASSOCIATION
TEAM NORMAN 2016/ 2017
COACHING APPLICATION FORM
Female Midget AAA Regional team
(Female players born in 1999 /2000 / 2001)
NAME ______
ADDRESS ______
CITY/TOWN ______
POSTAL CODE ______TELEPHONE ______(RES.)
______(BUS.)
______(FAX) ______(E-MAIL)
TEAM APPLIED FOR : Position ______
Positions Available-
Head Coach
Assistant Coach
Safety
Manager
PRESENT COACHING POSITION (If applicable)
TITLE ______
TEAM ______
CATEGORY ______
LEAGUE ______
NATIONAL COACHING CERTIFICATION PROGRAM
(Please fill out all areas that are applicable).
A. TECHNICAL/PRACTICAL CERTIFICATION
Coach Level (Level I) ______Year Attained ______
Intermediate Level (Level II) ______Year Attained ______
Advance Level (Level III) ______Year Attained ______
Advance II Level (Level IV) ______Year Attained ______
B. THEORY
Level I ______Year Attained ______
Level II ______Year Attained ______
Level III ______Year Attained ______
INDIVIDUAL COACHING AWARDS
Year ______Award ______
Year ______Award ______
IDENTIFY YOUR COACHING POSITION(S), TEAM(S) AND CATEGORY(S) THAT YOU HAVE BEEN INVOLVED WITH:
POSITION TEAM CATEGORY
2016-17______
2015-16 ______
2014-15 ______
LIST YOUR CONTRIBUTIONS TO NORMAN / HOCKEY MANITOBA (i.e. volunteer Hockey Manitoba Hockey Camps, Norman Camps, NCCP instructor etc....)
2016-17______
2015-16 ______
2014-15 ______
REFERENCES
Please list three (3) references that would be familiar with your coaching style and over all coaching abilities.
A. NAME ______
ADDRESS ______
CITY/TOWN ______POSTAL CODE ______
TELEPHONE ______(RES.) ______(BUS.)
B. NAME ______
ADDRESS ______
CITY/TOWN ______POSTAL CODE ______
TELEPHONE ______(RES.)______(BUS.)
C. NAME ______
ADDRESS ______
CITY/TOWN ______POSTAL CODE ______
TELEPHONE ______(RES.) ______(BUS.)
BACKGROUND CHECK
In accordance with the Hockey Canada Abuse and Harassment policies adopted by Hockey Manitoba, all provincial team coaches must be subject to a police check.
I agree that if I am considered for any coaching position, I would complete a police background check (at Norman Minor Hockey expense) If required.
______
Applicants Signature
APPLICATION DEADLINE IS May 15, 2016
All applications must be completed in full and should be directed to:
For more Information on these teams, coaching positions or application forms please contact;
Norman Regional Minor Hockey Association
Mike Kohli 204-676-2031