Applicants are being accepted for the positions of 2010-11 TCAHA youth hockey coaches for house Mite, Squirt, PeeWee, Bantam, and Midget, as well as rep Squirt, PeeWee, Bantam, and Midget (U16 & U18).   Applicants interested  should complete the applications below. Interviews will be conducted following receipt of applications.   To be considered you must have a  USA Hockey  Coach Card and have completed an Acxiom background check.  You must submit proof of these to Dustin Beck at president@tcaha.com

Please complete all of the following information.  Incomplete applications will not be considered.

First Name   MI Last Name

Address

City      State      Zip

Primary Phone    Secondary Phone

Email

Date of Birth       Gender   Male     Female
Citizenship US     Other

I am applying for Head Coach Assistant Coach On-Ice Helper Team Manager
     Team Manager is exempt for USA Hockey fee.
I would like to coach the following level House Rep

I would like to coach the following age group BP (2003 or younger) Mite (2001-2002) Squirt (1999-2000) PeeWee (1997-1998) Bantam (1995-1996) Midget (1991-1994)

USA Hockey Coaching Card Number

USA Hockey Certification Level Level 1 Level 2 Level 3 Level 4 Level 5

Date certification achieved

I have completed the Axciom background check Yes     No
If selected, you have 30 days to complete the background check.

The following information should be completed by Head Coach applicants only.

Last level coached  BP Mite Squirt House Squirt Rep PeeWee House PeeWee Rep Bantam House Bantam Rep Midget House Midget Rep

Second choice for level this year BP Mite Squirt House Squirt Rep PeeWee House PeeWee Rep Bantam House Bantam Rep Midget House Midget Rep

Do you want to attend a coaching clinic at the next level?Yes   No

Please explain your coaching philosophy.

Provide a brief description of you coaching experience.

Please detail your playing experience.

Please explain you disciplinary history in all sports.

Please list two references who can vouch for your coaching capabilities and ethics.
Name   Phone

Name   Phone