Part-Time: Head Coach / Junior Assistant / Referee
Application Form
Westkhoops Programs
Name
*
First Name
Last Name
Please provide your Birthdate:
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please indicate which Program (s) you are most interested in Coaching & Assisting?
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Please Select the Part-Time Position you are most interested in Coaching, Reffing, or Assisting:
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Camp Coach
Camp Youth Assistant
Camp Volunteer
Club League Youth Assistant
Club League Volunteer Coach
Referee
Please Select grade or age group you are interested in Coaching or Assisting
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Grade 4 & 5 (Ages 10 & 11)
Grade 6 & 7 (Ages 12 & 13)
Grade 8 & 9 (Ages 14 & 15)
All Age Groups
Only Boys
Only Girls
Co-ed
What is your Highest Level of Basketball Playing Experience:
*
Please Select
Never Played
Play for Fun (Occasionally)
Played on Middle School Team
Played on High School Team
Played Club League
Played on Elite Team (BC Basketball, etc.)
Played College/University
Played Professionally
Please list Coaching, Reffing, and/or Youth Related Certifications:
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Please list any Active First Aid Certificates or Certifications:
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Please list previous Coaching, Reffing, or Volunteer Experience:
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How would you describe yourself as a Youth Sports Coach, Assistant, or Referee? What is your Coaching, Reffing, or Assistant Coach philosophy (winning, having fun, discipline, teamwork, etc...?)
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Describe your previous work with Children & Youth Sports Programs? Describe your previous volunteer experience and how it fits with our Youth Sports Program/Camp?
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Have you ever been Formally Disciplined from a Youth Sports Program either as a Coach, Parent or Observer?
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No
Yes, please explain below:
Explain the discipline, restriction, limitations
Please provide two Coaching, Assistant, Reffing, or Volunteer References:
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Please list any children you have who are participating and registered in WestKHoops:
If selected to be a Coach, Assistant, Referee, or Volunteer with Westkhoops, do you agree to a Local Background Check (+18 Only)?
*
Please Select
Yes
No
Job Ad - Part-Time Coach, Jr. Assistant, Referee
If selected for a Position what is your desired Salary?
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e.g., $10 - $25 per hour
Terms and Conditions
*
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Submit
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