2022-2023 Rep Bench Staff Approval Form (Ajax Pickering Minor Hockey)

2022-2023 Rep Bench Staff Approval Form

All bench staff must be approved by the APMHA. Fill out the form below with ALL of your intended bench staff; this form should only be submitted once.

TEAM INFORMATION

Division:^*

Required

Level:^*

Required

HEAD COACH

First Name:^*

Required

Last Name:^*

Required

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

TRAINER

First Name:

Last Name:

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

ASSISTANT COACH/ASSISTANT TRAINER #1

First Name:

Last Name:

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

Team Position:

ASSISTANT COACH/ASSISTANT TRAINER #2

First Name:

Last Name:

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

Team Position:

ASSISTANT COACH/ASSISTANT TRAINER #3

First Name:

Last Name:

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

Team Position:

MANAGER

First Name:

Last Name:

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

Is the Manager being rostered to the Team?

YesNo

TREASURER

First Name:

Last Name:

Date of Birth:

Primary Phone Number:

Example: ###-###-####

Email Address:

Example: [email protected]

ON-ICE VOLUNTEERS

Please add any on-ice volunteers here:

2022-2023 Rep Bench Staff Approval Form (Ajax Pickering Minor Hockey)

OMHA Digital Network

TEAM INFORMATION

HEAD COACH

TRAINER

ASSISTANT COACH/ASSISTANT TRAINER #1

ASSISTANT COACH/ASSISTANT TRAINER #2

ASSISTANT COACH/ASSISTANT TRAINER #3

MANAGER

TREASURER

ON-ICE VOLUNTEERS

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