VALLEYVIEW MINOR HOCKEY TEAM MANAGEMENT APPLICATION

NAME / HOME PHONE:
ADDRESS / WORK PHONE:
CELL PHONE:
EMAIL:
DATE OF BIRTH / Alberta Health No:
DIVISION APPLIED FOR
Coaching requirements are listed beside each level of hockey and will be a requirement to coach. Please see end of application for explanations of each course. VVMHA holds annual coaching clinics and will assist all coaches, trainers and managers in getting the proper certifications by November 15thof the current hockey season. VVMHA will reimburse for the associated course costs for those needing to be certified or re-certified.
Pre-Novice - Requires completion of Hockey Canada Initiation program
Novice - Requires NCCP Coach Level Course
Atoms - Requires NCCP Coach Level Course
Pee Wee - Requires NCCP Coach Level Course and Checking Skills Program
Bantam - Requires NCCP Coach Level Course and Checking Skills Program
Midget - Requires NCCP Coach Level Course and Checking Skills Program
TRAINING
Have you completed the Hockey Canada Safety Program? / YES NO
Have you completed the Hockey Canada NCCP Coach Level Course? / YES NO
Have you completed the Hockey Canada Checking Skills Program? / YES NO
Have you completed the Hockey Canada NCCP Developmental A Level? / YES NO
Have you completed the Mandatory Respect in Sport Coaches course?
(application will not be accepted unless course certificate is attached) / YES NO
Have you completed the RCMP criminal records check?
(application will not be accepted unless course certificate is attached) / YES NO
ADDITIONAL INFORMATION
Have you ever been subject to disciplinary action by VVMHA, Hockey Alberta or the All Peace Minor Hockey League? YES NO
If yes, please provide explanation:
COACHING POSITION APPLIED FOR
HEAD COACH ASSISTANT COACH TRAINER MANAGER
RECENT COACHING EXPERIENCE
SEASON / TEAM/DIVISION CATEGORY / ORGANIZATION / ROLE
PLAYING EXPERIENCE
HIGHEST LEVEL PLAYED / NUMBER OF YEARS PLAYED
MINOR HOCKEY
SENIOR HOCKEY
JUNIOR HOCKEY
COLLEGE HOCKEY
PRO HOCKEY
DECLARATION
I declare that the information provided in this application is accurate and truthful at the time of completion:
SIGNATURE: / DATE:

ATTENTION:As previously noted, Valleyview Minor Hockey Association requires that all coaches, assistant coaches, trainers and managers provide to the Association an RCMP Criminal Records Check. This form must be submitted to the President prior to any scheduled tryout, practice, or game. Failure to comply with this policy will result in the individual forfeiting their right to serve on the bench or on the ice in any capacity. VVMHA will not “card” the individual with Hockey Alberta.

PLEASE NOTE: In order to get the Criminal Record Check completed you must take picture id with you to the local RCMP Detachment. Their office hours are 8:00 a.m. to 4:30 p.m. Monday through Friday. The process will take two (2) days to complete and must be picked up at the detachment. Applicants will present a completed Criminal Record Check to the President for review, but VVMHA will not keep the original Criminal Record Check or copy of the same.

Deadline for coaching applications is Thursday, September 5, 2013 at 6:00 p.m.

Give completed application and crimal checks to:

Rhett Czaban, President

Cell: 780-524-8331

Criminal Record Check Declaration
I declare that the Criminal Records Check of applicant has been reviewed, approved and returned to applicant:
PRESIDENT SIGNATURE: / DATE: