FOOTHILLS COACHING APPLICATION
NAME:
EMAIL CONTACT:
TELEPHONE CONTACT:
POSITION INTERESTED IN:
Coach
Assistant Coach
Manager
COACHING POSITION PREFERRED
GENDER: Male
Female
LEVEL: Premier
Competitive
Age Group 1st Choice:
U10
U12
U14
U16
U18
Age Group 2nd Choice:
U10
U12
U14
U16
U18
COACHING EXPERIENCE
Do you have any previous coaching experience?
Yes
No
If yes, please explain:
What NCCP (National Coaching Certificate Program) level do you currently have?
0
1
2
3
4
Please select the highest CSA Coaching level to you currently have?
Nothing Yet
Community Coach Children
Community Coach Youth
Community Coach Senior
Pre-B
Provincial B
National B
A-License
Other, please explain:
You are currently certified in CPR and First Aid:
Yes
No
You have valid CPIC (Police Clearance)Clearance?
Yes
No
What other clubs have you coached for in the past? Check all that apply.
SWU
NWU
Chinooks
Blizzard
NSD
Another club not listed?
Are there any additional comments. Please use the text box below to explain:
