2023-2024 House League Coach Application (Ajax Pickering Minor Hockey)

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Thank you for your interest in coaching with the Ajax Pickering Raiders! The APMHA is grateful to it's many volunteer coaches and bench staff for dedicating their time and hard work to youth hockey in our community. If you are interested in coaching a House League team for the upcoming 2023-2024 season, please complete this form in it's entirety. *IMPORTANT*: Submitting this form does NOT guarantee you will be accepted as a Coach for a HL team. Confirmed coaches will receive an email with further details and instructions.

GENERAL INFORMATION

First Name:^*
Last Name:^*

Date of Birth:^*

Open the calendar popup.

Email Address:^*

Example: [email protected]
Primary Phone Number:^*

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

COACHING INFORMATION

Please indicate what division you are interested in coaching this season:^*
U7
U8
U9
U11
U13
U15
U18/U21
Check All That Apply
Do you have a child playing in this division(s):^*
YesNo (non-parent coach)
If yes, please list the players name(s):

Please include the first and last name of your player.
Do you have a Trainer request? Please note that only ONE coach request will be accepted.^*
YesNo
If yes, please provide the name of your bench staff request:

Please include First/Last Name

COACHING QUALIFICATIONS

Certification Level:^*
No Certification
Coach 1 - Intro to Coach (Trained)
Coach 2 (Trained)
Development 1 (Trained/Certified)
HTCP Level 1 (Trainer)
Check All That Apply
Have you completed the Respect in Sport Activity Leader Course?^*
YesNoUnsure
This course is NOT the same as the RIS for Parents Course. If you are unsure if you have completed this course, APMHA staff will verify.
To the best of my knowledge, APMHA has a VALID Vulnerable Sector Police Check on file:^*
YesNoUnsure
If you are unsure, APMHA staff will verify.

COACHING EXPERIENCE

1. Organization:
Team(s):
Position:
Season(s):
2. Organization:
Team(s):
Position:
Season(s):
References:

If you would like to provide a reference with your application, please include the First Name/Last Name and Phone Number of your Reference.

Submitted applications are sent to the APMHA for review. The submission of this application does NOT guarantee that applicants will be selected to coach a House League team for the 2023-2024 season. Selected coaches will be contacted by the APMHA with further details/instructions. Please allow 2-4 weeks for a response from APMHA administrative staff. Waitlist for coaches will be in effect.

Any bench staff requests made above are not guaranteed.

By submitting this application, the applicant agrees to any and all APMHA House League rules and regulations; this includes, but is not limited to, balancing the House League teams. All coaches agree to balance House League teams, if required by the association.

The APMHA reserves the right to make changes to any team bench staff both prior to, and during, the upcoming season.

I agree to the terms and conditions stated above.^*

Human Validation

Check The Box ^*

2023-2024 House League Coach Application (Ajax Pickering Minor Hockey)

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