Port Dover Minor Baseball Association
Port Dover Minor Baseball Association Coaches application for the 2017 season Full Name: ____________________
Telephone Evening:
Address: _____________________
Telephone Day:
_____________________
Sex:
M
F
Are you 18 years of age or older?
1. What team do you wish to coach? 2. Why do you want to coach this team?
Coaching Back Ground 3. Have you played baseball? Y N 4. What other sports have you played?
Number of years?
List sports – age level - years played
5. Do you have previous baseball coaching experience? Number of years? With what organization?
6. What other sports have you coached? List sport – organization – age level – years coached
Y
N
Y
N
Port Dover Minor Baseball Association Coaches application for the 2017 season
7. Do you have any formal baseball training as a coach? List training - Include your NCCP# if you have one
Y
N
8. Describe any informal training that would help you as a coach? For example, clinics, books etc.
9. Have you ever been convicted of a crime for which a pardon has not been granted? Y
N
If yes, please explain.
10. Upon acceptance of a coaching position (should one be offered to you) you will be required to obtain a criminal back ground and vulnerable sector police check. Is this a problem? Y N
11. Please list the names, addresses and telephone numbers of two persons who you can use as a coaching or personal reference.
For PDMBA executive use. Date Received?
Telephone Evening:
Address: _____________________
Telephone Day:
_____________________
Sex:
M
F
Are you 18 years of age or older?
1. What team do you wish to coach? 2. Why do you want to coach this team?
Coaching Back Ground 3. Have you played baseball? Y N 4. What other sports have you played?
Number of years?
List sports – age level - years played
5. Do you have previous baseball coaching experience? Number of years? With what organization?
6. What other sports have you coached? List sport – organization – age level – years coached
Y
N
Y
N
Port Dover Minor Baseball Association Coaches application for the 2017 season
7. Do you have any formal baseball training as a coach? List training - Include your NCCP# if you have one
Y
N
8. Describe any informal training that would help you as a coach? For example, clinics, books etc.
9. Have you ever been convicted of a crime for which a pardon has not been granted? Y
N
If yes, please explain.
10. Upon acceptance of a coaching position (should one be offered to you) you will be required to obtain a criminal back ground and vulnerable sector police check. Is this a problem? Y N
11. Please list the names, addresses and telephone numbers of two persons who you can use as a coaching or personal reference.
For PDMBA executive use. Date Received?
