Head Coach Application

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Chelsea Hockey Association

PERSONAL INFORMATION

Name *

Email *

Phone Number *

TEAM INFORMATION

Team (8U Bulldogs, 2003 Chiefs, etc) *

Season

HOCKEY EXPERIENCE

What is your current CEP Level? *

When does your CEP expire?

Have you completed any Module training? *

10U

12U

14U

16/18/19U

None

Required

Please list your most relevant coaching or playing experiences (Year, Position, Level ,Team) : *

ADDITIONAL INFORMATION

Have you coached youth sports before? *

Yes

What is your coaching philosophy? *

Additional information or qualifications you feel are important about yourself:

Please list any coaches you would like to work with:

Is your work schedule flexible enough to attend 90% of all team events? *

Yes

If "No", please explain why:

REQUIREMENTS

I understand that I must: 1. Register with USA Hockey, 2. complete age-specific modules, 3. complete Safesport training, 4. pass a USAH background screening, 5. Complete a USAH CEP clinic by 12/31. Note - all costs incurred can be reimbursed by CHA

I have read and agree to the Requirements listed above. *

Yes

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