AVAHA Coaching Application
THANK YOU FOR YOUR INTEREST IN ASHLEY VALLEY AMATEUR HOCKEY! 
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NAME: 
DATE OF BIRTH: 
AGE: 
 *
ADDRESS:
CONTACT #: 
EMAIL:
 *
PREFERRED DIVISION: *
COACHING POSITION APPLYING FOR:
*PLEASE LIST 1ST & 2ND CHOICE PREFERRED.
 *
HAVE YOU EVER PLAYED HOCKEY BEFORE?  *
IF YES, HOW MANY YEARS?
HAVE YOU EVER COACHED HOCKEY BEFORE?  *
IF YES, HOW MANY YEARS? WHERE HAVE YOU COACHED? WHAT AGE DIVISION HAVE YOU COACHED?
EXPLANATION OF EXPERIANCE:
DO YOU HAVE CURRENT CEP LEVEL MODULES? 
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IF YES, WHAT LEVEL AND DATE COMPLETED? 
DO YOU HAVE CURRENT SAFE SPORT AND USA HOCKEY BACKGROUND CHECK? 
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IF YES, WHAT DATES DID YOU COMPLETE SAFESPORT AND USA HOCKEY BACKGROUND CHECK? 
WHAT IS YOUR CURRENT USA HOCKEY NUMBER? 
DO YOU HAVE PLAYERS PLAYING THIS SEASON? 
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IF YES, PLEASE LIST YOUR PLAYER'S NAMES AND BIRTH YEARS.
DOES YOUR WORK SCHEDULE ALLOW YOU TO ATTEND PRACTICE AND GAMES REGULARLY? 
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PLEASE EXPLAIN. 
OTHER INFORMATION AVAHA SHOULD KNOW? 

I understand that USA Hockey and the Coaching Education Program require both certification and registration to be eligible to coach. Registration is done online on a yearly basis. Certification is also required. A few basic steps requirements are as follows:

USA Hockey Requirements (Must be completed before participating in any team activities)

·         Register as a member of USA Hockey. (Cost is $46 plus any affiliate fees if applicable).

·          Complete the background screening. 

·         Complete the USA Hockey Safe Sport Training. (Required every year and cannot be added to a roster until completed.)

·         Complete the online age-specific module(s) for the age level of play you are coaching. (Cost is $10 per module and only needs to be completed once per age level. Must be completed PRIOR to participating in any team activities and cannot be added to a roster until completed) 

·          Coaching Education Program Certification Clinic Requirements (Must be completed by Dec. 31 each season) The Cost is $55. You can only attend one clinic per season and all coaches start at Level 1. You can take clinics from April 1-Dec. 31 each season.   

For more information please go to www.usahockey.com

 

I hereby affirm that the information contained in this application if truthful and correct and am willing to complete the coaching requirements listed above.

IF YOU AGREE AND UNDERSTAND THE ABOVE STATEMENT PLEASE TYPE YOUR NAME. 
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