West Kootenay Minor Lacrosse Association

Coaching Application Form

SECTION 1. CONTACT INFORMATION

Name of Applicant: ______

(Given Name) (Middle Name) (Surname)

Address:______

(Street address) (City) (Postal Code)

Birth Date: ______

Telephone: (Home or Cell) ______(Work)______

EmailAddress:______

SECTION 2. TEAM APPLICATION

Preferred Coaching Assignment: Head Coach Assistant Coach  On Floor Helper 

Preferred Division Assignment: Mini-Tyke  Tyke  Novice  Peewee  Bantam  Midget 

Would you be willing to coach a team that you did NOT apply for? Yes  No 

If so, please indicate which team(s):______

SECTION 3. EXPERIENCE AND QUALIFICATIONS

What is your NCCP Coach Level? Community  Competitive  Not certified 

If you have not coached for WKMLA in the last 2 years, please provide your NCCP info if you know it.

Year Obtained:______Certification Number: ______

BCLA requires Community Development certification for Mini-Tyke to Peewee and Competitive Development certification for Bantam to Midget. Are you certified for the level for which you are applying? Yes  or No 

If you are not certified at the required level, are you available to attend the Coaching Clinic planned for March1011, 2018? Yes or No 

Note: Coaching Clinics are available at alternate location. Will you make yourself available to attend an alternate Clinic? Yes or No 

Lacrosse Coaching Experience (list in order, starting with the most recent)

YEAR / ASSOCIATION / AGE GROUP / POSITION

West Kootenay Minor Lacrosse AssociationCoaching Application Form1|Page

SECTION 4: REFERENCES

If you have not coached for WKMLA in the last 2 years, please provide the name of individual(s) who can be contacted about your coaching experience.

NAME / HOME NUMBER / OTHER NUMBER

Please submit any references you would like considered

SECTION 5. COACHING PHILOSOPHY(For Head Coach Applicants only)

Why are you interested in Coaching?______

How long are you hoping to coach for?

This season only  1-2 years  3+ years  As long as my child plays  Other (please explain)

______

What is your coaching philosophy?

______

What, in your opinion, is a successful season?

______

What is your personal opinion on the subject of equal floor time?

______

How would you discipline players in the following scenarios?

1. Disrespect towards the coaching staff: ______

2. Disrespect towards fellow team members: ______

3. Habitual lateness or unexcused absence from practice(s): ______

4. How do you intend to convey team rules to the parents? (Check all that apply)

In writing  Parent meeting(s) Through team manager  Tell the players verbally 

Undertakings:

  1. I consent to the disclosure of the above information.
  2. I acknowledge the authority of the CLA, the B.C. Lacrosse Association and West Kootenay Minor Lacrosse Association and agree to carry out and abide by their constitutions, bylaws, rules and regulations.
  3. I agree to familiarize myself with the National Coaching Certification Program (NCCP) requirements for coaching minor lacrosse and ensure that I maintain the required level of certification.
  4. I agree to complete a Criminal Record Check (CRC) and a Vulnerable Sector Check (VSC). I understand that I could be suspended from coaching if I fail to provide a CRC/VSC. I understand that the outcome of my CRC/VSC will be forwarded to the designated screening officer of the WKMLA who will keep my file confidential. I understand that if there is a problem with my CRC/VSC, WKMLA may refer my file to the BCLA Volunteer Screening Officer for a resolution.

Signature:______Date: ______

Print Name: ______

Please Mail of E-mail the completed form to:

, or WKMLA, PO Box 249, Rossland, BC, VOG 1YO

West Kootenay Minor Lacrosse AssociationCoaching Application Form1|Page