2022-23 NVMHA Volunteer Coach Application
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First Name
Last  Name
Address
full address including postal code
Phone
Mobile
Phone alternate
What other number can we contact you at?
Email address
Date of Birth
MM
/
DD
/
YYYY
Hockey Canada Record (HCR) Number
can be found on your hockey canada profile
Are you currently under probation or suspension from coaching duties within any other association
Clear selection
If yes, please provide details:
Have you ever been convicted of a criminal offense
Clear selection
Do you have criminal charges pending?
Clear selection
If yes to either of the previous two question please provide details
NVMHA requires all volunteers, employees and contractors to complete a Criminal Records Check or Volunteer Disclosure Form annually. Forms for both can be found in the Coaches>Resources section of the NVMHA website. Please confirm you under stand this requirement. *
Coaching Assignment Requested  FIRST CHOICE
Coaching Assignment Requested  SECOND CHOICE
Please indicate certification and training that you have completed
Coaching Experience  2020-21 Season
include team, level,  association and your position
Coaching Experience 2019-20 season
include team, level, association and position
Coaching Experience 2018-19 season
include team, level, association and position
Other relevant experience
Briefly describe your coaching philosophy
Do you have a child registered in NVMHA
Clear selection
Are you willing to coach a team your child is not on?
Clear selection
If a coaching position were not available in the age group of your choice, would you be willing to coach in another division and/or help out with skill development and player evaluation?
Clear selection
If yes, which division?
Do you have the required certification level for the team for which you are applying??
Clear selection
If not certified at the required level, are you willing and available to take the appropriate course to attain the required level of certification?
Clear selection
Coaching References
Please provide the name, phone and email for three coaching references
Undertaking *
 I hereby consent to disclosure of the above information.  I hereby agree to obtain a criminal record check and any subsequent back ground checks as required by the association and BC Hockey.  I hereby acknowledge the authority of the BC Hockey, PCAHA and the North Vancouver Minor Hockey Association and agree to carry out and abide by their constitution, bylaws, rules and regulations.   I hereby agree to familiarize myself with the National Coaching Certification Program (NCCP) requirements for coaching minor hockey and ensure that I maintain the required level of certification.
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