Grassroots Event Facilitator Application

Applicant Information

First Name *

Last Name *

Email *

Mailing Address *

City/Town *

Postal Code *

Home Phone *

Work or Cell Phone *

Coaching Qualifications:

Note*

Please check off all certifications you have acquired

Respect in Sport Yes

Coach 1 Intro Yes

Coach 2 Level Yes

Checking Yes

Development 1 Yes

Goalie Coach Yes

High Performance 1 Yes

High Performance 2 Yes

Other Training (please explain)

Have you been involved with Hockey Saskatchewan before? *

Yes No

If YES, what programs and years?

Are you currently playing/managing or coaching a team? *

Yes No

If YES, what team(s) and division(s)?

Why do you want to get involved with Hockey Saskatchewan? *

Please list any relevant Coaching/Instructor history (last 5 years):

Coach Resume

No bigger than 5MB

Hockey Reference #1

No bigger than 5MB

Hockey Reference #2

No bigger than 5MB

Criminal Record Check

Please upload a copy of your criminal record check to the link below:

https://upload-mcdougallgauley.titanfile.com/sGGWGN

Media Release and Consent Agreement: I consent to be included in photographs, video, print and/or other similar material and further agree to the use and distribution of the materials, and any copies, for advertising purposes in any Hockey Saskatchewan publications or other media. * Yes

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Grassroots Event Facilitator Application