Coach and Manager Nomination Form

 

NAME OF NOMINEE:        

 

                                                (First Name)              (Surname)

SCHOOL:                                                     PHONE NO:

 EMAIL ADDRESS:                                     MOBILE:     

POSITION APPLIED FOR:

Under 13:  Boys/Girls

Under 15: Boys/Girls

Under 18: Boys/Girls

Senior: Men/Women

Veterans: Men/Women         

 

CURRENT COACHING QUALIFICATIONS: (Tick appropriate Level)

Level O ……  Level 1  ……  Level 2 ……   Other  ……………….

PRIOR COACHING EXPERIENCE:

MANAGERIAL EXPERIENCE:

CURRENT FIRST AID/SPORTS MEDICINE QUALIFICATIONS:

PROVIDER; (eg St John’s)              LEVEL:

POLICE CHECK:      Yes/No                BLUE CARD NUMBER:

PERSONAL APPRAISAL RE – SUITABILITY FOR POSITION:

 

 

 

 

 

CODE OF CONDUCT: I have read and understood the Code of Conduct.     

YES/NO

I agree to attend a coach/manager in-service session if required.

SIGNATURE OF NOMINEE:                                              DATE:

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