Next Shift Leadership Program Application
Fill out the form below to be considered as a mentor for the new Next Shift program
General Information
Player Name
*
First Name
Last Name
Player Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current Grade Level
*
Freshman, Sophomore, Junior, Senior
Player Email
*
example@example.com
Player Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 1 Name
*
First Name
Last Name
Parent 1 Email
*
example@example.com
Parent 1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 2 Name
First Name
Last Name
Parent 2 Email
example@example.com
Parent 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Family Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Players...Please Answer The Questions Below!
Why do you want to be part of this program?
*
Why do you want to coach younger players?
*
Who has been an important mentor in your life?
*
What did that person teach you?
*
What does leadership mean to you?
*
What is something you are currently trying to improve about yourself?
*
What do you think a 10-year-old hockey player needs from a 15- to 18-year-old mentor?
*
Tell us about a time you failed or faced adversity. How did you respond?
*
What kind of person do you want to become?
*
Coaching Experience
Have you ever coached in any capacity before?
*
Yes
No
A Tiny Bit
If you selected "yes," what experience do you have?
When thinking about coaching, does it make you a bit nervous or intimidated? if so, why?
If you have ever skated with Hull Hockey, what did you like the most?
Thats It! Click submit when finished. We will be in touch!
Submit
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