SPECIAL OLYMPICS TEAM USA
2015 SPECIAL OLYMPICS WORLD SUMMER GAMES
Head Coach/Assistant Coach Application Form
SOPA DEADLINE –Tuesday, JUNE 24, 2014The mission of Special Olympics Team U.S.A. is to provide for the leadership and management of a united national team of delegates, athletes and coaches from all eligible U.S. Programs, delivering a quality athlete experience through participation in World Games.
Position Summary: Each Head Coach/Assistant Coach will beappointed by the Management Team to organize, prepare, and provide leadership, direction and oversight to the athletes of their respective sport, from the time of their selection through the post-Games Debrief. Each Head Coach is to work directly with their sport assistant coaches to ensure the athletes for their sport delegation experience the athletic, physical, cultural and social benefits of participating in a World Games.
Select the sport(s) for which you would like to be considered. In each of your selected sports, √ (check) whether you’d like to be considered for one or the other or both - the Head Coach and/or an Assistant Coach position. NOTE: Team USA does not select coaches for team sports – coaches & teams come together.
Aquatics □ Head Coach □ Coach / Athletics □ Head Coach □ Coach
Bocce □ Head Coach □ Coach / Bowling □ Head Coach □ Coach
Cycling □ Head Coach □ Coach / Equestrian □ Head Coach □ Coach
Golf □ Head Coach □ Coach / Gymnastics □ Head Coach □ Coach
Kayaking □ Head Coach □ Coach / Powerlifting □ Head Coach □ Coach
Tennis □ Head Coach □ Coach / Sailing □ Head Coach □ Coach
Please prioritize the sport(s)for which you’d like to be considered.
1st Choice: ______2nd Choice: ______3rd Choice: ______
Do you have Special Olympics Certification in each sport you selected? □ Yes □ No
Do you have NGB Certification in each sport you selected? □ Yes □ No
General Information (please print or type)
First Name: / Last Name:
Address:
City, State, Zip:
Gender: / Male / Female / Date of Birth: / / / /19
Day Phone: / ( ) / Eve. Phone: / ( )
Cell Phone: / ( ) / Fax: / ( )
E-mail Address: / @
Special Olympics Program Name:
Staff experience w/ Special Olympics: State: ______Position: ______Year began: _____
Volunteer experience: State: ______Event(s): ______Year began: _____
Are you currently certified in any of the following?
First Aid□ YES□ NOExpiration: ______
CPR □ YES□ NOExpiration: ______
American Sign Language□ YES□ NOExpiration: ______
Other (please list): ______
______
Do you have previous experience with Team USA, National Games and/or World Games? / □ YES □ NOIf yes, please explain:
Share your experience working directly with SO athletes: ______
______
______
______
Do you have overnight experience supervising/chaperoning athletes? □ Yes □ No
Rate yourself in the following characteristics:
Very Strong / Strong / Average / Needs Improvement
Teamwork / 4 / 3 / 2 / 1
Leadership / 4 / 3 / 2 / 1
Detail oriented / 4 / 3 / 2 / 1
Conflict Resolution / 4 / 3 / 2 / 1
Decision Making / 4 / 3 / 2 / 1
Problem Solving / 4 / 3 / 2 / 1
Management / 4 / 3 / 2 / 1
What is your coaching philosophy?
What is your knowledge & experience with the sport(s) you are requesting? Please be specific and include your role(s)
intraining, education and competition experiences.
What relevant experiences and qualities do you bring to the team?
What are your reasons for submitting an application for a Head Coach/Coach position?
Areyou able to commit to attending training camp, October 2-7, 2014? (Head Coaches – October 1-7, 2014) / Yes □ No / No
Are you able to commit to be on-site with the delegation the entire length of World Games & Host Town? / Yes □ No / No
Can you meet all other pre-Games, Games-time and post-Games requirements described in the Head Coach/Assistant Coach Job Description? / Yes □ No / No
Do you understand the process for financial reimbursement and budgetary expenditures? □ Yes □ No
Do you understand a current Volunteer Background Check is required to complete your application? / Yes □ No
UNIFORM INFORMATION
HeightfeetinchesWeight pounds
Waist ______Inseam______
Hat sizeSMLXL2XL
Men’s shirt sizeSMLXL2XL3XL
Men’s short/pant sizeSMLXL2XL3XL
Men’s warm up suit sizeSMLXL2XL3XL
Women’s shirt sizeSMLXL2XL
Women’s short/pant sizeSMLXL2XL
Women’s warm up suit sizeSMLXL2XL
Youth shirt sizeSMLXL
Youth short/pant sizeSMLXL
Youth warm up suit sizeSMLXL
- I have read and understand the job description and general expectations of this position and that the information I havegiven Team USA is true and complete. I understand the Team USA Management Team may remove me from the delegation if I fail to meet the requirements of the job description or act outside the Code of Conduct.
- This form needs to be signed by your U.S. Program President/CEO and the head of Sports/Program to confirm their endorsement of your application. If it is not signed, the application will not be accepted nor reviewed.
Signature of Applicant / Date
- All applicants must complete and attach the following materials:
Sports/Program staff, unless the applicant is in this position.
□ Timeline and detail of Special Olympics work history.
□ Letters of Support. You are required to submit three letters of support. A letter from the
the Sports/Program Director from your state Program and 2 letters from among: your supervisor
at work; a Special Olympics family member or volunteer; or a Special Olympics athlete.
□ Code of Conduct. Sign and attach the Code of Conduct to application.
□ All application materials need to be submitted as a single unit by: Friday, June 27, 2014.
□ All application materials will be reviewed and each nominee will be informed of selections.
U.S. Program Staff Section
Volunteer Background Check/Protective Behaviors
We certify this individual is current on their Volunteer Background Screening. □ Yes □ No
Date check conducted: ______
We certify this individual is current on their Protective Behaviors. □ Yes □ No
Date taken. ______
This form needs to be signed by the U.S. Program’s President/CEO and Sports/Program Director to confirm their endorsement of your application. If it is not signed, the application will not be accepted or considered.______
Signature of President/CEO Date
(unless the applicant is in this position)
______
Signature of Sports/Program Director Date
(unless the applicant is in this position)
Please submit by: Friday, June 27, 2014
Chris
Special Olympics Kansas913-236-9771 (fax)
5280 Foxridge Drive
Mission, Kansas 66202
If you have questions call Chris at 913-236-9290 ext. 104 or email
Special Olympics Team USA Code of Conduct
Special Olympics is committed to the highest ideals of sport and expects all coaches to honor Sport and Special Olympics. All Special Olympics Team USA delegation members agree to observe the following code:
I.RESPECT FOR OTHERS
A.I will respect the rights, dignity and worth of athletes, coaches, other volunteers, friends and spectators in Special Olympics.
B.I will treat everyone equally regardless of sex, ethnic origin, religion or ability.
C.I will be a positive role model for the athletes I coach.
II.ENSURE A POSITIVE EXPERIENCE
A.I will ensure that for each athlete I coach, the time spent with Special Olympics is a positive experience.
B.I will respect the talent, developmental stage and goals of each athlete.
C.I will ensure each athlete competes in events that challenge that athlete’s potential and are appropriate to that athlete’s ability.
D.I will be fair, considerate and honest with athletes and communicate with athletes using simple, clear language.
E.I will ensure that accurate scores are provided for entry of an athlete into any event.
F.I will instruct each athlete to perform to the best of the athlete’s ability at all preliminaries and final heats in accordance with the Official Special Olympics Sports Rules.
III.ACT PROFESSIONALLY AND TAKE RESPONSIBILITY FOR MY ACTIONS
A.My language, manner, punctuality, preparation and presentation will demonstrate high standards.
B.I will display control, respect, dignity and professionalism to all involved in the sport (athletes, coaches, opponents, officials, administrators, parents, spectators, media, etc.).
C.I will encourage athletes to demonstrate the same qualities.
D.I will not drink alcohol, smoke or take illegal drugs while representing Special Olympics at training sessions, competition or during Games.
E.I will refrain from any form of personal abuse towards athletes and others, including inappropriate or unwanted sexual advances on others, verbal, physical and emotional abuse.
F.I will be alert to any form of abuse from other sources directed toward athletes in my care.
G.I will abide by the Special Olympics policy on the prohibition of coaches dating athletes.
IV.QUALITY SERVICE TO THE ATHLETES
A.I will seek continual improvement through performance evaluation and ongoing coach education.
B.I will be knowledgeable about the Sports Rules and skills of the sport (s) I coach.
C.I will provide a plan for a regular training program.
D.I will keep copies of the medical, training, and competition records for each athlete I coach.
E.I will follow the Special Olympics Sports Rules for my sport (s).
V.HEALTH AND SAFETY OF THE ATHLETES
A.I will ensure that the equipment and facilities are safe to use.
B.I will ensure that the equipment, rules, training and the environment are appropriate for the age and ability of the athletes.
C.I will review each athlete’s medical form and be aware of any limitations on that athlete’s participation noted on that form.
D.I will encourage athletes to seek medical advice when required.
E.I will maintain the same interest and support towards sick and injured athletes.
F.I will allow further participation in training and competition only when appropriate.
I understand that if I violate this Code of Conduct I will be subjected to a range of consequence, up to and including being prohibited from volunteering for Special Olympics.
Signed: ______Date: ______
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