2023 - 2024 REP Coach Application (Whitchurch Stouffville Minor Hockey Association)

Print 2023 - 2024 REP Coach Application

Personal Information

Name^*
Telephone Number

Example: ###-###-####
Other Contact Number

Please enter a second contact number.
Email Address^*

Example: [email protected] A copy of your application will be sent to this address for your records

Date^*

Date of Submission

Team Selection

Which age group are you apply for?^*
Which level are you applying for^*
AAA
Check All That Apply
Select from this list a 2nd choice
Select from the list a 2nd choice of team level
AAA
Check All That Apply
If either of your 2 choices are not available, would you be interested in coaching another level?^*
YesNoPossibly
Will you have a child playing on the team you are applying for? ^*
YesNoOther
If YES to above question, can you please state their name
What was the level your child played last season?

example: U9 AE or U10 HL
Being as objective as possible, would you please place your child in the top 3rd, middle 3rd or bottom 3rd of competative players in this age group

400 characters

Coaching Qualifications

Please fill in all the certifications that you have.

Do you have your Respect in Sport Activity Leader (RIS/PRS/Speak Out)^*
YesNo
Do you have an up-to-date Vulnerable Sector Check (VSC) from a Police Department on file with the WSMHA^*
YesNo

Expiry Date of VSC if you know it

If not, do you agree to obtain a VSC from the regional Police Department that you reside in prior to acceptance as a Head Coach^*
YesNo
Coach 1 or Intro to Coach^*
YesNoN/A
Coach 2 or Development 1 - Mandatory for Rep Coaches from U9 - U12^*
YesNoN/A
Development 1 - Mandatory for U13 and above^*
YesNoN/A
If you have no certifications, do you agree to obtain the proper coaching certifications by September 30, 2023^*
YesNo
Use this box to tell us about any other coaching certificates you may have. List what other sport/organization that may apply

500 characters

Coaching Experience

Last team you were involved with. Please list team name, year, level of team and your position on that team.^*

List the teams you have been either a head coach, assist coach, manager trainer. 500 characters
2nd last team you were involved with. Please list team name, year, level of team and your position on that team.

List the teams you have been either a head coach, assist coach, manager trainer. 500 characters
Briefly describe any training programs or other clinics you have attended, may be for other sports etc.

500 characters
Coaching goals, objectives and philosophy

Briefly describe you coaching goals, objectives and philosophy. 500 characters
Use this box to tell us about any other coaching experience you may have.

500 characters

References

Please provide names and contact information of up to 3 references that we may contact. One being a parent reference.

Human Validation