JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
PCMLA Coaches Application
Thank you for your interest in coaching with Port Coquitlam Minor Lacrosse. We will be in touch with all applicants as the season approaches. If you have any questions, please email Jon Church at
headcoach@pocominorlacrosse.com
.
All PCMLA coaches will be required to complete:
a Criminal Record Check
All pre-course work (On-Line Coach Certification Pre-Course Modules)
a Level 1 (U7, U9, U11, U13) or Level 2 coaching certification (U15, U17)
Your PCMLA Head Coach will work with you to schedule any clinics.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Address
*
Your answer
City
*
Your answer
Postal Code
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Date of birth (MM/DD/YYYY)
Your answer
Desired coaching position?
Select all that apply. Please note for trainers: you must be certified a minimum of first responders (firefighter, ambulance, armed forces personnel, medical professional, etc.) or have an approved and valid trainer’s certificate.
*
Head coach
Assistant coach
Trainer
Required
Division preference
Select all that apply.
*
U7
U9
U11
U11 Female
U13
U13 Female
U15
U15 Female
U17
U17 Female
Required
Indicate names(s) of Head Coach or Assistant Coach you might wish to work with
Please note for head coach applicants; have all potential assistant coaches submit an application as all coaches must be approved by PCMLA.
Your answer
NCCP #
If first time coaching please enter -
new
or if you don't know -
forgot
.
*
Your answer
Indicate NCCP levels you have completed
Select all that apply.
*
Box Level 1 - Community Development Trained
Box Level 2 - Competitive Introduction Trained
No certification
Required
Coaching experience?
Brief summary of your coaching experience (list any/all sports, levels, years coached).
*
Your answer
Do you anticipate having a child on the team you are applying to coach?
*
Yes
No
Required
Your lacrosse experience?
Select all that apply.
*
No lacrosse playing experience but eager to help!
Played minor/masters
Played Jr/Sr/College
Played pro NLL/MLL/PLL
Required
Any additional information or comments?
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
