IMHA, Ilderton Minor Hockey Association. Home of the Jets!

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2009-2010 Coaching Application

Please submit online by May 31, 2009.
or if by mail send to: 1999 Sunningdale Rd. E., London, ON N5X 3Y5

Your Personal Information:
*Surname
*First Name
*Address
*Postal Code
*E-mail
Verify E-Mail
Home Phone		Cell Phone
Application:
Team(s) Applying for: eg. Midget Boys Shamrock
If your choice(s) are not available would you consider another team? Yes No
Certifications:
CHIP (Initiation)	Coach Level
Intermediate	Advanced		1 2
Coach Stream	Development		1 2
PRS (Speak Out)	High Performance		1 2
	HTCP Level		1 2

Coaching Experience:
Are you currently active with IMHA? Yes No If yes, in what capacity?
Please list previous coaching experience:

What do you feel are your coaching strengths:

Please share with us your thoughts on the following:
Practices

Player Development

Ice Time

Winning / Losing

Parental Feedback

Please list the names of your Team's potential bench staff:
Assistant Coach 1:
Assistant Coach 2:
Trainer
Other
Will you have a son/daughter trying out for the team? Yes No
If yes, are you confident they will clearly make this team? Yes No Explain
Please list three references who we may contact (no relatives please):
Name	Phone (H)	Phone (C)
1:
2:
3:
Other Comments:

If selected, I agree to abide by all rules, regulations and programs established by the OMHA/OWHA and/or the IMHA. Police background checks must be completed each year before you are considered for a coaching position! Please contact a member of the IMHA Executive regarding police check information. Please note the following: Some applicants may be contacted for an interview. All applicants will be notified via phone or email. Applications must be received by May 31, 2009. By clicking SUBMIT, you are agreeing to abide by all rules, regulations, and programs established by the OMHA/OWHA and/or the IMHA if you are selected. You also agree to the above mentioned references being contacted and give permission to these persons to provide information about yourself to the IMHA. Complete Application by clicking “SUBMIT” Below. If Mailing, send to: Chris Talbot 1999 Sunningdale Rd. East, London, N5X 3Y5

	If you are mailing your application please print, date and sign in the space provided below to indicate your acceptance of the above terms.
Date	Print Name	Signature