2021-22 Copper Country Junior Hockey Association

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2021-22 Copper Country Junior Hockey Association - Travel Team Coach Application

Please fill out all information.

Email *

Name *

Address *

Phone Number

enter in xxx-xxx-xxxx format

Team Division You Are Applying for: *

Do you have a player in this level? *

Yes

Please indicate USA Hockey Certification *

Please Indicate Coaching Experience (for example, 8U, 10U, etc, and time coached) and how long you have coached. *

Please describe your coaching philosophy and what you see as important goals and perspectives: *

Please indicate other coaching or related experiences that the board should consider: *

Are there any felony or misdemeanor charges against you? *

Yes

Have you ever been convicted of a misdemeanor or a felony? *

Yes

If yes to either of the above, please give date, charge and disposition:

I acknowledge that I have received and read the Copper Country Junior Hockey Association Travel Coach Description and Duties document. The document is available at: https://tinyurl.com/y6alyqkt (link will either open or download a .pdf file) *

Yes

I certify that the answers in this application and other information submitted are true and to the best of my knowledge. I realize that all information furnished by me is important and that any misrepresentation of facts shall constitute cause for dismissal regardless of when discovered by CCJHA. I authorize all individuals and agencies both public and private to release information regarding me as referenced in this application to CCJHA on a confidential basis. (please type name as signature) *

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