For NEW Applicants ONLY: Please attach coaching resume and letter of interest along with this application.
Please print legibly and complete all information. Illegible or incomplete applications will be returned. Please attach a copy of current US Lacrosse membership card, if available. Please attach a copy of current CPR and First Aid Certification, if available. Submit completed application and supporting materials directly to Club VicePresident .
Date:
Position Applied For (Print exact Title, including Head or Assistant Position, Age Level):
Last Name:
First Name:
Middle Initial:
Address:
Male/Female:
City:
State:
Home Phone:
Zip:
Date of Birth:
Cell Phone:
Contact Email: Occupation:
Current Employer:
PLAYING/COACHING EXPERIENCE
List High School, College or Adult League playing experience (Any sport): School/Organization, Team and Level Years Positions Played
List any previous coaching experience (Any sport): School/Organization, Team and Level Years Position
SBLC Version 3, December 2015
List any coaching education or certifications: Certification Organization Date Received
Do you currently have a child in the program?
Please list children and ages?
Do you have current CPR and First Aid certifications? If
Have you ever been convicted of a felony or misdemeanor,
Yes, please attach copy of certification.
other than minor traffic violations?
If any prior convictions, please explain: Please list any restrictions or conditions of your availability to coach:
Please discuss your coaching philosophy, include strengths you have which will enable you to contribute to the development of our student/athletes and our athletic program. Indicate any attributes you feel would distinguish you from other candidates for this position. (Use additional sheet, if necessary):
SBLC Version 3, December 2015
COACHING REQUIREMENTS AND DISCLAIMER Initials:
I will support and abide by the Snohomish Boys Lacrosse Coach's Code of Conduct I will complete and submit all information for a criminal background check required each year by the club.
Initials:
I will support Snohomish Boys Lacrosse Club, its rules/policies, board of directors and members. I will Initials: abide by its bylaws and read and uphold all rules of the associated leagues. Initials: I will attend CPR and First Aid training and maintain and provide proof of current certifications. I will attend concussion training and follow all rules, timelines and restrictions associated with Snohomish Boys Lacrosse's Concussion Policy.
Initials: Initials:
I will attend any league or club coach's meetings as required Disclaimer:
I hereby certify that the statements made and the information supplied are true and complete to the best of my knowledge. I further understand that any false or misleading information on any part of the application constitutes cause for rejection of my application or dismissal after assignment of a position within the club. My signature below authorizes the Snohomish Lacrosse Club to obtain any or all records or information in regards to my application for a coaching position, including contacting any personal or professional references. Signature:
Date:
ADMINISTRATION USE ONLY: Received by: Title: Date: Time: Received via: