Bluewater Hawks Coach Application
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age group you are applying for
Please Select
U9
U11
U13
U15
U18
U22
Sr
Level
Please Select
Elite
AA
A
BB
B
C
HL
Have you completed the Hockey Canada "Respect in Sport" program
Yes
No
Please list your coaching certifications and dates obtained
Are you certified to coach the level you are applying for?
Yes
No
If no are you willing to take the nesessary weekend clinic(s) to satisfy the requirement?
Yes
No
Are you comfortable with independents assigned by the executive assisting in evaluating and making the team?
Yes
No
Coaching Experience: (list in order, starting with most recent)
Rows
Association
Level
Position
1
2
3
4
5
What area's do you feel are most important to developing for the age of player that you are applying to coach?
If applicable do you feel your child will make the team for which your applying for?
Yes
No
Which portion of the team do you feel she will make
Bottom
Middle
Top
Daughter's Name
First Name
Last Name
Association daughter played in last year
Age group your daughter played in last year
Please Select
U9
U11
U13
U15
U18
U22
Sr
Level your daughter played last season
Please Select
Elite
AA
A
BB
B
C
HL
Reference #1
First Name
Last Name
Reference # 1 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #2
First Name
Last Name
Reference #2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I hereby consent to the disclosure of the above information
Signature
Please upload any other Information you feel is applicable.
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