STHA Travel Head Coach Application

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Please complete the following application to be considered for a Head Travel Coach position within the Southern Tier Hockey Association.

Your submission will be sent to Scott Beattie, STHA, VP of Travel Operations for review.

Head Coach positions will be posted for 10 days.

STHA membership will be asked to provide feedback on all coaches who have applied (7 day feedback period).

Head coach interviews to follow the feedback period. Date TBD.

Email *

Last Name *

First Name *

Date of Birth *

YYYY

Cell Phone Number *

Address *

What is your previous coaching experience? (Include all sports in addition to hockey) *

For which Level would you like to be considered? (Check all that apply) *

18UAA

18UA

16UAA

16UA

16U B (Independent/Snowbelt)

14UAA

14UA

14U B(Independent/Snowbelt)

12UAA

12UA

10UAA

10UA

8UAA

8UA

Required

Why do you want to coach for the STHA? *

Have you ever been convicted or plead guilty to a crime? *

Yes

Have you ever been held liable for civil penalties or damages involving sexual or physical abuse?
*

Yes

Have you ever been subject to any court order involving any sexual or physical abuse of a minor, including but not limited to a domestic order of protection?
*

Yes

Have any complaints ever been made against you either at work or in your capacity as a volunteer that you verbally, emotionally, sexually or physically abused a minor?
*

Yes

Do you have a history of any behavior that might make you a danger to any children, youth or adolescents in this program?
*

Yes

Have you ever been denied a volunteer coaching position in the past?
*

Yes

Do you have any additional information you would like to provide as to why you should be considered for a coaching position? *

List 3 references. Only one reference may be a family member.

Reference Name #1 *

Reference Phone Number *

Reference Name #2 *

Reference Phone Number

Reference Name #3 *

Reference Phone Number

I certify that all information given by me in this application is true and correct to the best of my knowledge. I understand that false or misleading statements made by me or consequential omissions of any kind in the application process, are sufficient cause for my not being accepted as a volunteer or for my dismissal no matter when discovered. I authorize Southern Tier Hockey Association to investigate all information contained in this application. The employers, organizations and individuals named are authorized to give you any and all information regarding my employment, volunteer work, character, fitness and qualifications (including opinions) that they may have about me. In consideration of the evaluation of this application by Southern Tier Hockey Association, I HEREBY WAIVE, RELEASE AND DISCHARGE Southern Tier Hockey Association, all employers, organizations, and individuals and any other persons or entities from liability for all damages and losses of whatever kind or nature, except liability for willful or intentional acts or punitive damages, that may result from compliance or attempts to comply with this authorization. The submission of a coachʼs application does not guarantee a coaching position for the season. The number of coaches required, experience and references will all be considered when appointing coaches. The Southern Tier Hockey Association reserves the right to place coaches in positions where they are most critically needed.
*

Yes

Electronically sign or type your initials in the space below *

A copy of your responses will be emailed to the address you provided.

Submit

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