Windham Youth Cheerleading New Coach Application

Windham Youth Cheerleading New Coach Application
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Social Security Number (SSN)
Driver's License Number
Coaching Position Desired Note: Coaching assignment subject to registration needs, consideration given to children/parents in the program.

Other
If you chose Other, please explain:
Experience – Please list your experience as an athlete:
Experience – Please list your experience as a coach:
Experience – Please list your experience with tumbling, stunting, choreography, etc.:
Special Training, Skills or Certifications (volunteering, CPR, nursing, childcare, youth groups, Sunday School, Scouts):
Have you had any other names in the past (i.e. maiden names)? Please list them all. If not input N/A.
Do you have children in a Windham Youth Cheerleading program? (circle one)
If Yes above, Name of Cheerleader and Grade for Fall 2026:
References

For high school assistants, please include parent contact as Reference #1 below. For all others, please list two references (other than relatives) that can inform us about your abilities and qualifications for this position.
Reference #1 Name

First NameLast Name
Reference #1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference #1 Email
example@example.com
Reference #1 Relationship:
Reference #2 Name

First NameLast Name
Reference #2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference #2 Email
example@example.com
Reference #2 Relationship:
By providing my electronic signature, I certify that all information submitted to Windham Youth Cheerleading is true and accurate. I acknowledge that this signature serves as my agreement to this attestation and a background check and that I will also be required to review and sign a separate Code of Conduct. Signature
Date Signed:
Should be Empty:

Windham Youth Cheerleading New Coach Application

References