Pleasant Hill Fighting Fish

APPLICATION FOR SWIM or DIVE TEAM COACH EMPLOYMENT

You must fill out this application to be considered for a coaching position.

Please fill out application COMPLETELY and LEGIBLY. Must be received by March 15th, 2012.

Mail to: Marsha Birch -PHSC Swim Team, 6118 Flemington Rd., Centerville, Ohio 45459 or email to

Name: ______Social Security #: ______

Address: ______City: ______Zip: ______

Date of Birth: ______Email address: ______

Home Phone #: ______Cell Phone #: ______

Emergency Contact (name, phone, and relationship):

All paid coaching staff must be at least 16 years old by end of current year Swim/dive season and have ALL of the certifications listed below.

Mark all positions you are interested in applying for with an X(Any position you have not marked you will not be considered for, check all positions you would be willing to do.)

Head Swim Coach Assistant Swim Coach Head Dive Coach Assistant Dive Coach

***Miniuim age for a Jr Coach is 14 years during the current swim/dive season.***

Jr. Swim Team Coach Jr. Dive Team Coach

A Jr. Swim and Dive coach is a non-paying position. Your Swim Team fees will be waived if you are selected and become a Jr. coach. All Jr. Coaches are required to be at every Swim/Dive Team practices and events, just like the other coaches.

Are you applying for any other position at Pleasant Hill Swim Club? Yes No

Certifications: The position you are applying for requires the following certifications, you must be current for the entire swim season. Please provide a copy of each updated certification. Only Jr. Coaches don’t need the following certifications.

American Red Cross CPR/First AidExpiration Date: ______

American Red Cross LifesavingExpiration Date: ______

Days Available – Must be available for all PHSC Swim and/or Dive Team Events. This includes daily M-F morning practices, afternoon practices(only before Centerville schools are out for the summer), some extra weekend events, meets, banquets and all other activities. Swim/Dive Team starts in May and goes into the middle of July. This is approx. an 8 week time period. Season begins day after Mermorail Day goes thru third week in July

List any conflicts which may interfere with your work schedule: ______

I certify that, to the best of my knowledge and belief, all of the information on and attached to this application is true, correct, complete, and made in good faith. I understand that false or fraudulent information on or attached to this application may be grounds for dismissal.

Signature: ______Date: ______

FOR PHSC OFFICE USE ONLY

Interview Date: ______Hire Date: ______Position Title: ______Pay Rate: $______