CMHA COACH APPLICATION FORM
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Are you applying for a Rep (A) or Rec (C) position? (Click all that apply)
*
Rep (A)
Rec (C)
Open to both
What division do you want to coach (U7, U9, U11, U13, U15, U18, U21)?
*
Will you coach another division, if you aren't given your first choice?
*
Yes
No
Will you have a child trying out for the team you have applied for
*
Yes
No
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Certification Taken & Dates Obtained
RESPECT IN SPORT (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
COACH 1 (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
COACH 2 (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
BODY CHECKING (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
HCSP (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
DEVELOPMENT 1 (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
HIGH PERFORMANCE 1 (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
CATT (Concussion Awareness Training Tool) (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
CRC (Criminal Record Check) (Answer yes or no. If yes, please provide the date obtained)
*
No
Yes (Enter date obtained)
OTHER (GOALTENDER, ETC). Please note dates obtained if applicable.
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Please answer the following to the best of your ability
1. Outline your coaching philosophy:
*
2. Most memorable achievement as a coach (any sport):
*
3. Most memorable disappointment as a coach (any sport):
*
4. Why do you want to coach hockey with CMHA? (List all reasons)
*
5. List previous hockey coaching experience (Age group, league, years)
*
6. Please list any other relevant experiences (Player evaluation, hockey school, camps, provincial or national experiences):
7. Is there any other information you'd like to share?
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Please include the names of 2 people who are familiar with your coaching background:
Reference 1
*
Please provide full name of reference, relationship, phone number and email
Reference 2
*
Please provide full name of reference, relationship, phone number and email
Thank you for taking the time to complete your personal profile for CMHA and for your interest in becoming part of our coaching team! Click the submit button below, when you're ready to send in your application.
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