COMPETITION-INTRODUCTIONONTARIO MULTI-SPORT LEARNING FACILITATOR–APPLICATION FORM
Please check if you are interested in applying for additional LF status:
___ Advanced Learning Facilitator
WORKSHOP PREFERENCES
THE CAO WORKS WITH DIFFERENT TYPES OF AFFILIATE LOCAL PARTNERS. PLEASE INDICATE YOUR INTEREST IN FACILITATING WORKSHOPS IN THE FOLLOWING: (You may choose one or multiple.)
____ Community Centres - Municipalities____Universities or Community Colleges
____ Community Sports Councils____ Provincial Sport Organizations
____ Highschools____ Aboriginal Communities
PLEASE INDICATE IF YOU ARE CURRENTLY AFFILIATED (e.g. Faculty) WITH ANY EDUCATION INSITUTION OR MUNICIPALITY. ____ YES ____ NO
WHERE DO YOU PLAN TO FACILITATE COMPETITION - INTRODUCTION?______
GEOGRAPHIC AREAS WILLING TO TRAVELGEOGRAPHIC AREA OF PRIMARY INTEREST
____ Eastern Ontario____ Eastern Ontario
____ Northwestern Ontario____ Northwestern Ontario
____ Northeastern Ontario____ Northeastern Ontario
____ Central____ Central
____ Southwestern Ontario____ Southwestern Ontario
SPECIAL INTERESTS / FOCUS
____ Youth Coaches (Age 16-18)
____ Aboriginal Communities
____ Women Coaches
____ Paralympics (Coaching Athletes with a Disability)
EDUCATION BACKGROUND
Education/Études
Post-Secondary Education/Études postsecondaires
Period of study/Période d’étudesInstitution/ÉtablissementCredit Received
From/Du To/Au Name/Nom Crédit obtenu
In addition to attaching your NCCP Transcript obtained from the CAC database please list additional information regarding the following:
Advanced Coach Education/Formation avancée en entraînement
From/Du To/AuInstitution / Program Description Year/Année
□WAS A PRESENTER AT COACHING CONFERENCES, CLINICS & WORKSHOPS
______
Name of event & location Year
______
Name of event & location Year
______
Name of event & location Year
In your view, what 3 or 4 topics do you think Ontario coaches should be invited to discuss when they get together in a multi-sport group?
Please attach any additional information or statements about your background that you feel would contribute to becoming a Learning Facilitator for the multi-sport modules offered within NCCP.
Please check all that apply and indicate the number of years or timeframe on the right.
Coaching Roles Age of Athletes Coached
POSITION / YEAR(S)Assistant Coach
Program Coach
Head Coach
Mentor Coach
POSITION / YEAR(S)
Youth under age 8
Ages 8-12
Ages 13-18
Ages 19-22
Adults
Seniors (Age 55+)
Program Level Coached
Sport(s) Coached
POSITION / YEAR(S)Elementary or Highschool
College or University
Club or Community League
Provincial Team
National Team
Coaching Opportunities / Experience
POSITION / YEAR(S)National team selection camp
Regional Championships (sport-specific)
Provincial Championships (sport-specific)
Canadian Championships (sport-specific)
National Team
International events (sport-specific)
World Championships (sport-specific)
Provincial Multi-sport Games
Canada Games
Commonwealth Games
Pan-Am Games / Para Pan-Am Games
Olympic Games / Paralympic Games
DECLARATION
I hereby certify that the information I have provided with this application is true.
Signature of Applicant
Please send your application information to:
Coaches Association of Ontario
Suite 108 – 3 Concorde Gate
Toronto, ON M3C 3N7
FAX 416-426-7331 or
Email:
Your application must include the following. Forms are available on CAO website.
□Completed LF Generic Modules
□Completed Multi Sport Module(s) Workshop for which you are applying
□Completed Membership Requirement
□Completed MED Online Evaluation
□Completed Cover Letter
□Completed APPLICATION FORM
□Signed NCCP Code of Conduct
□Transcript of your NCCP Certification Status
□References
All applications will be acknowledged upon receipt.