Nickel Centre Minor Hockey Association
Online Coaching Staff Application for the 2008/2009 season
(All positions require a separate application)
Fields marked with * are Mandatory

Position Applying for

* Position: Select a position Coach Assistant Coach Trainer Manager Any position

* League:  Select league House Rep

* Division:  Select a Division Initiation ( House League only) Tyke (House League only) Novice Minor Atom Atom Minor Peewee Peewee Minor Bantam Bantam Minor Midget (House League only) Midget Any Division   (minor teams are in Rep league only unless otherwise noted)

Name & Address

* Last Name:

* First Name:

* Street Address: 

* City:         * Postal Code:

* Res. Phone #:        Bus. Phone #:       Ext: 

Email address:

Previous Experience

Certification

Coaching Certification #:   CN

Trainer Certification #:    TN
Trainer certificates are valid for 3 years from month of issue. Is yours valid:    Yes   No    Don't know

Speak Out Certification #:     HN

Initiation Certification #:     IN

Body Checking Certification #:     BN

A valid police check is required for all positions on a N.C.M.H.A. team.
A police check is valid for 4 years from date of issue.

* Do you have a valid Police check on file with the N.C.M.H.A.    Yes   No

In the event you do not have a valid police check you will require one prior to being accepted on a team's staff.