DCG GIRLS BASKETBALL CLUB – COACHING APPLICATION

DCG GIRLS BASKETBALL CLUB – COACHING APPLICATION

Personal Information



Last Name

First Name

Middle Name



Date of Birth

City

State Zip E-mail Address

Mailing Address

Convenient Time to Contact You Home Number

Work Number



Day or C-Phone



Coaching Information Coaching Position Desired

Coaching Experience (Note: No experience required)

Head Coach Assistant Coach None Rec Organized Youth Middle School Age Level Desired



High School

Other

Names and Ages of Children Participating in League

3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade











Coaching Request – (not required)







General Information Thank you for expressing an interest in the DC-G Girls Basketball Club. We appreciate your desire to become a valued and integral part of the Association. We practice the ideals of sportsmanship, scholarship, and physical fitness. Our program stresses learning lessons of value far beyond the playing days, such as, self-discipline, teamwork, leadership, and good sportsmanship. Competent, dedicated, and responsible coaching is without a doubt the primary catalyst for achieving these goals. To this end, the Club attempts to identify individuals within the community with the same commitment and philosophical attributes that the Club itself was founded upon. An application and interview process, conducted by the League Board of Directors and/or their designees serves as a fair and impartial means by which prospective coaches can be selected and recommended to the full Board for approval. It is the Club’s purpose and intent to entrust our youth with coaches that are positive role models, display good moral character and have demonstrated the skills and abilities necessary to effectively and positively impact our youth participants. Please answer the following questions (Yes/No): 1. Will you adhere to the provisions and guidelines outlined in the Club Coaches Code of Conduct? ___________ (A signed and dated copy of the Code of Conduct must be attached to this Application) 2. Have you ever been arrested? _______ If Yes, provide the date, charge, location and disposition on Page 2 of this application. 3. Have you ever been convicted of a crime including sex abuse or child abuse related offenses? _______ If Yes, provide the date, charge, location and disposition on Page 2 of this application. 4. I hereby authorize the DCG Girls Basketball Club to conduct a criminal background check ________ 5. Are you currently certified in Iowa with a Coaching Endorsement / Authorization? _______ Folder Number_______ Exp. Date_______ 1

Have you participated in any formal training/instruction/education relative to athletic coaching? _______ If Yes, indicate in narrative: ___________________________________________________________________________________________ _________________________________________________________________________________________ 7. If selected to coach I will: o Arrive to practice on time, utilize the time efficiently, and be prepared o Attend the practice led by the high school staff o Be willing to learn and assist the high school staff during practice Please state in detail any qualifications, educational background, previous coaching experience, or other considerations that would assist you in performing the duties and responsibilities for which this application is submitted. _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ If you answered ‘yes’ to questions 2 or 3, please provide date, charge, location, and disposition below: _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ I hereby certify that all facts contained in this application are true and complete to the best of my knowledge. I understand the Club may investigate any and all information provided to assist in assessing my suitability and qualifications for the position which I have applied, and release all parties from any liability and/or damage that may result from said action. I understand this and all positions are appointed upon the approval of the Board of Directors of the DCG Girls Basketball Club and the Board of Directors, and any person approved and designated as such will hold that position for no definite period of time and may, regardless of the date of appointment or approval, be terminated at any time without prior notice for whatever reason(s) the Board deems necessary or appropriate. _______________________________________________________ Applicant’s Signature Date 6.

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