2023 COACHING APPLICATION

2023 COACHING APPLICATION
NAME
ADDRESS
CITY
STATE
ZIP CODE
EMAIL ADDRESS*
CELLULAR TELEPHONE
HOME TELEPHONE
PROGRAM APPLYING FOR:
POSITION APPLYING FOR:
DIVISION

COACHING EXPERIENCE
ORGANIZATION
SPORT / YEAR
CITY / STATE
POSITION
ORGANIZATION
SPORT / YEAR
CITY / STATE
POSITION
ORGANIZATION
SPORT / YEAR
CITY / STATE
POSITION

DO YOU HAVE CHILDREN IN THE PROGRAM?
IF YES, LIST FULL NAME AND DIVISION
DO YOU HAVE A VALID DRIVERS LICENSE?
IF YES, LIST NUMBER, DATE, AND STATE
HAVE YOU EVER BEEN CONVICTED OF OR PLEAD GUILTY TO ANY CRIMES?
IF YES, DESCRIBE EACH IN FULL
HAVE YOU EVER BEEN CONVICTED OF DOMESTIC VIOLENCE?
IF YES, DESCRIBE EACH IN FULL
HAVE YOU EVER BEEN REFUSED PARTICIPATION OR PUT ON PROBATION BY ANY OTHER YOUTH PROGRAMS OR ASSOCIATIONS?
IF YES, LIST ORGANIZATIONS AND EXPLAIN THE CIRCUMSTANCES

REFERENCES
NAME:
ADDRESS/ TELEPHONE
NAME:
ADDRESS/ TELEPHONE
NAME:
ADDRESS/ TELEPHONE
NAME:
ADDRESS/ TELEPHONE

As a condition of volunteering, I give permission for DCJC to conduct a background check on me, which may include a review of sex offender registries, child abuse, and criminal history records. If selected, I am subject to probation, suspension, and/or removal by the Board of Directors for any violations of DCJC's Code of Conduct.

Every Coach:

1. Will be required to pass a background check and to be certified under SYF regulations.

2. Must attend mandatory meetings, clinics, and complete SYF coaching clinic.

3. Must attend walk-in registration and public/recruiting events.

4. Will promote and demonstrate good sportsmanship, character, and leadership.

I declare the above information to be truthful. If I am selected to a position, I will adhere to all the standards, expectations, and Coaches Code of Ethics set forth by the DCJC.
I agree and consent to the above statement
Upload a File

Cancelof
Should be Empty: