HOCKEY NEWFOUNDLAND & LABRADOR HIGH PERFORMANCE PROGRAM COACHING STAFF APPLICATION FORM

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1 HOCKEY NEWFOUNDLAND & LABRADOR HIGH PERFORMANCE PROGRAM COACHING STAFF APPLICATION FORM January, 21 st /2014 Please find enclosed a coaching staff application form for the 2014 High Performance Program. All of the positions provide a valuable development opportunity for Newfoundland & Labrador coaches. If you are looking for an opportunity to work with high- level hockey players while at the same time, working with and learning from very accomplished and respected hockey coaches, you should think about getting involved in the High Performance Program. This is a unique opportunity for you to get involved and have a very rewarding and worthwhile hockey experience. Because this is a year leading up to the Canada Winter Games, positions are available for Male U14, Male U15 and Female Under 15. For your convenience we have broken this application into 5 parts: Time Commitments/Requirements: Page 2 NCCP Requirements Page 2 Personal Information/Desired Position/Team: Page 3 Present Coaching Situation: Page 3 National Coach Certification Program - Status: Page 3 Experience Charts: Pages 4 & 5 Disclosure Form Page 6 Please note that the deadline for receiving applications is February 21, Yours in Hockey, Ken Chafe Hockey Development Chair Hockey NL 1

2 Time Commitments/Requirements: HOCKEY NEWFOUNDLAND & LABRADOR HIGH PERFORMANCE PROGRAM COACHING STAFF APPLICATION FORM Male U14 Staff: Attend spring identification camps (May 9 th - 11 th Goulds) Conference Calls leading up to Summer Evaluation Camp 2014 HPP Summer Evaluation Camp; August 7 th - 12 th (Gander) 2014 Atlantic Challenge Cup: October 9 th - 13 th (Moncton, NB) Male U15 Staff: Attend spring identification camps (May 2 nd 4 th Goulds) Conference Calls leading up to Summer Evaluation Camp 2014 HPP Summer Evaluation Camp; August 12 th - 17 th (Gander) 2014 Atlantic Challenge Cup: October 9 th - 13 th (Moncton, NB) Female U15 Staff: Attend spring identification camps (May 2 nd - 4 th CBS & Botwood) Conference Calls leading up to Summer Evaluation Camp 2014 HPP Summer Evaluation Camp; August 17 th - 22 nd (Gander) 2014 Atlantic Challenge Cup: October 9 th - 13 th (Moncton, NB) *Coaches must have their High Performance 1, (formerly referred to as Advanced Level 1) and that one new assistant coach may be considered with Developmental 1 certification on the understanding they complete HP 1. **Please note for all staff, unforeseen time commitments may be added. 2

3 1. Personal Information: Name: Home Address: Home Phone #: Business Phone #: Fax: E- mail: Birth date: (mm/dd/yr) Jacket Size: Shirt Size: Track- Suit Size: (XS- S- M- L- XL- XXL) 2. Coaching Staff Position applying (please rank in order of preference, 1 being highest) Team Head Coach Asst. Coach Trainer Director of Operations Goalie Coach Male Under 14 Male Under 15 Female Under Present Coaching Situation Current Team(s) Coached: Coaching Position(s) on Current Team(s) Coached: Category of Team(s): 4. National Coach Certification Program (NCCP) Highest Level of NCCP Certification Attained: Date of Completion: 3

4 5. Experience Charts (Please fill in the required fields) EXPERIENCE AS AN INSTRUCTOR (HOCKEY SCHOOLS, CLINICS OR OTHER RELATED ACTIVITIES) EXPERIENCE AS A PLAYER SEASON NAME OF TEAM POSITION DIVISION/CATEGORY COMMUNITY PARTICIPATION (SEMINARS, COACHING SYMPOSIA OR OTHER RELATED ACTIVITIES) SEASON NAME OF TEAM POSITION DIVISION/CATEGORY COMMUNITY EDUCATION (PLEASE IDENTIFY THE HIGHEST LEVEL OF EDUCATION YOU HAVE ATTAINED) HIGH SCHOOL: COLLEGE: UNIVERSITY: OTHER: *REFERENCES NEW APPLICANTS ARE REQUIRED TO PROVIDE A LETTER OF RECOMMENDATION. THIS LETTER CAN COME FROM ANY OF THE FOLLOWING SOURCES: MINOR HOCKEY ASSOCIATION; A COACH WHO HAS WORKED IN THE HPP IN THE PAST; A COACH WHOM YOU HAVE WORKED WITHIN THE PAST; AN EXECUTIVE FOR A PAST TEAM YOU HAVE COACHED; OTHER RELEVANT SOURCE. 4

5 5. Continued EXPERIENCE AS A COACH (CLUB) - SPECIFY POSITION: HC (HEAD COACH) OR AC (ASSISTANT COACH) EXPERIENCE AS A COACH - PROVINCIAL (EG. HPP, ZONE CHAMPS) EXPERIENCE AS A COACH - REGIONAL (EG. ATLANTIC CANADA, ETC) EXPERIENCE IN ACOE / BRANCH PROGRAMS (IE. SKILLS CAMP, MENTORSHIP, COURSE CONDUCTOR, ETC) SEASON NAME OF TEAM POSITION DIVISION/CATEGORY COMMUNITY Other related involvements in the game not mentioned: 5

6 HOCKEY NEWFOUNDLAND AND LABRADOR HIGH PERFORMANCE PROGRAM DISCLOSURE FORM As per the Hockey Newfoundland and Labrador High Performance Program policy, all individuals who make application for staff positions within this program must disclose any activities that may be deemed to place the individual in a direct or potential conflict of interest with branch policies. All information relating to the individual involvement as well as any involvement of any and all related children with any team, league, or association within Hockey Newfoundland and Labrador must be disclosed. All other information relating to the individual s involvement with other hockey related activities including private hockey school and private hockey teams or ventures must also be reported. I, profess that all my involvement with hockey (Print Name) programs has been disclosed in the appropriate areas of the attached coach application form and/or in the space provided on this form. I also agree to inform Hockey Newfoundland and Labrador immediately if I do become involved with additional teams, leagues and/or associations, private or within Hockey Newfoundland and Labrador. Signature A copy of this form is to be completed by Applicants and returned to the HNL Branch Office by Friday, February 21, 2014 at 4:00pm. This form can be submitted to the HNL office by Fax (709) or by pdagg@hockeynl.ca *Hockey NL thanks all applicants for their interest, however; only successful candidates selected for an interview will be contacted. Any questions or concerns, please contact Paul Dagg (HNL, Technical Director) by pdagg@hockeynl.ca or by Phone (709) HOCKEY NEWFOUNDLAND AND LABRADOR 32 Queensway, P.O. Box 176, Grand Falls- Windsor, NF A2A 2J4 Tel: (709) , Fax: (709) E- Mail: office@hockeynl.ca Internet: 6