Notice: JavaScript is required for this content. AFHA REP Head Coach Application Fields marked with an * are required Personal Info Personal Information First Name * Last Name * Email * Phone * Address * City * Province * British Columbia Alberta Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code * Please indicate which Head Coach position(s) you are applying for * U13A U15A U18A Current Coach Credentials * COACH 1 - INTRO TO COACH COACH 2 - COACH LEVEL COACH - DEVELOPMENT 1 TRAINED COACH - DEVELOPMENT 1 CERTIFIED COACH - HIGH PERFORMANCE 1 NONE Last Coaching Staff Experience (Please indicate the year ie: 2019-2020 season) * Previous experience as a hockey coach and/or player. * Describe any previous experience you have coaching other sports. If you have any other relevant information you would like to add, please enter it below. References References Name 1 Phone 1 Name 2 Phone 2 Confirm you are willing to complete a Criminal Record Check for our organization prior to being selected for any coaching assignment * I consent that the information provided may be shared with the AFHA Board and AFHA Coach Selection Committee. * Please confirm that we may contact the references you have provided to discuss your coaching abilities * If you are a human seeing this field, please leave it empty.