Coach Application Form
Please answer all relevant questions to apply for a coaching position in WicklowHC for the season September 2021- April 2022.. Parent/guardians should apply on behalf of their children. If you have any questions, please contact Klaas Jan de Vries 0872311480.
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Full Name Applicant *
Coaching Qualification *
Other Relevant Hockey Coaching Qualifications (International)
Coaching Positions - Select Preferred Group(s)/Position - Groups with * are new depending on LHA decisions re leagues
Yes, I would like to be considered for a position
Coach
Assistant-Coach
Hockey ID (Intellectual Disabilities, 12+ mixed)
Fitness Hockey (mixed adults)
Goalkeeper Training
Pre-school, junior&senior infants (U6) Mixed
1st&2nd Class (U8) Mixed
3rd&4th Class Girls (U10)
5th Class Girls (U11)
6th Class Girls (E8-U12)
1stY Girls (E8-U13)
2ndY Girls (Minor-U14)
3rdY Girls (Intermediate-U16)
4thY Girls (Intermediate-U16)
5th&6thY Girls (U18)*
Senior Ladies
3rd&4th Class Boys (U10)
5th&6th Class Boys (U12)
1st&2ndY Boys (U14)
3rd&4thY Boys (U16)
U16 Boys Futures Group (selection)
5th&6thY Boys (U18)*
Senior Men
What is your ambition as a coach? What would you like to achieve through your coaching? What supports do you need? *
Safeguarding Children Level 1/Code of Ethics Certified - required if you are 16 years or older *
Safeguarding Children Level 1 Certificate Number - please provide if you have one
Safeguarding Children Level 1 Certificate Date
MM
/
DD
/
YYYY
Garda Vetted - compulsory if you are 16 or older *
Garda Vetting Date Completed
MM
/
DD
/
YYYY
Coaching Experience - please describe briefly *
I am available to coach on the following day(s)/time(s)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
Evening
Date of Birth Applicant - Under 18s must provide DOB
MM
/
DD
/
YYYY
Email Address - please provide number parent/guardian if you are under 18 *
Mobile Phone - please provide number parent/guardian if you are under 18 *
Full Name Parent/Guardian - required if applicant is under 18
Agreement - both boxes must be ticked if you wish to be considered *
Required
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