GPMHA House League Coaching Application (Petawawa Minor Hockey)

Print GPMHA House League Coaching Application

Applicants will be contacted by the House League Director before the season start to confirm certifications.

Postion and Division Information

Position Sought:^*
Division:^*

Personal Information

Full Name^*
Email Address^*

Example: [email protected]
Mailing Address:^*
Home Phone:^*

Example: ###-###-####
Mobile Phone:

Example: ###-###-####

Experience

Please list all coaching and volunteer jobs

Coaching Experience^*

Include Year, Association/Club, Team Name and Position

Training and Certifications

List all application Training and Certifications^*

Include Course Name, Location Taken, Date Completed/Last Certified

- I understand that a Criminal Record Check and Vulnerable Sector Screening must be completed in my name.
- I understand that I must attend either the O.P.P. Station or the M.P. Station to complete the paperwork for the Criminal Record Check and Vulnerable Sector Screening process.
- I understand that the GPMHAI collects and uses personal information for the sole purpose of the administration of the minor hockey program.
- I understand the information collected will not be shared with any third parties or outside agencies without prior consent.
- I understand that personal information collected will be kept and maintained in a secure area for the duration of my association with the GPMHAI unless otherwise directed to destroy it.
- I understand that each year, new information may be collected to update the information on file only.
I agree to the terms and conditions stated above^*

Human Validation

Check The Box ^*