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* 1. First Name

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* 2. Last Name

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* 3. Address

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* 4. Community Club Affiliation:

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* 5. What age group are you applying for?

NOTE: If Interested in more than one age group, a second application must be completed AND make note of your preference below.

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* 6. What level?

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* 7. Will you have your child player registered to play this upcoming season in the age division you are applying for?

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* 8. During the past two years, In your prior experiences as a head coach or assistant coach, have you ever been subject to disciplinary actions (i.e suspensions) by any association, such as, but not limited to, SBMHA, Hockey Winnipeg or Hockey Canada?

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* 9. In the last 5 years, have you served as a head coach in minor hockey?

If YES, please fill out the required information in the next 5 questions (if applicable).
If NO, skip to question #15.

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* 15. In the last 5 years, have you served as an assistant coach in minor hockey?

If YES, please fill out the required information in the next 5 questions (if applicable).
If NO, skip to question #21.

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* 21. What is the highest level of hockey you have ever coached?

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* 22. Please indicate all the levels of NCCP Certifications you currently hold.

(Be prepared to provide a copy of your Hockey Canada profile at some point during the coach selection process.)

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* 23. Please describe any other relevant coaching training and/or certifications you may have.

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* 24. Please check the appropriate boxes below to describe your experience as a player in hockey.

  1 Year Played 2 Years Played 3 Years Played 4 Years Played 5+ Years Played
House League
A Hockey
AA Hockey / High School
AAA
Junior
College / University
Professional

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* 25. Please indicate the languages you are able to communicate in.

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* 26. Do you have any reasons, medical or otherwise, that would preclude you from wearing a helmet while on ice?

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* 27. Have you ever been convicted of a criminal offense?

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* 28. Would your name appear on a Vulnerable Sector Check?

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* 29. Resolving Conflicts: Conflicts may arise when there are differences of opinion, belief or attitude. The ones rooted in differing values, needs, wants or perceptions will not always be easy to resolve. Please provide examples of how you would resolve conflicts  in the following scenarios...

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* 30. For the upcoming season, SBMHA has plans to work with coaches to provide a uniform player skills development program. If offered this opportunity, would you be willing to implement this as a part of your overall yearly plan?

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* 31. For the upcoming season, SBMHA has plans to work with Hockey Manitoba to provide a uniform coaching development program (no cost to coaches). If offered this opportunity, would you be willing to attend both classroom and on ice sessions?

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* 32. Outside of sports, do you have experience working with children either professionally or as a volunteer?

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* 33. Please provide any other comments, experiences or accomplishments that you believe should be considered as part this application.

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* 34. Please provide names and contact information for two references. These people must be capable of answering questions related to your coaching style & philosophy, your adherence to fair play, your coach conduct and interactions with players and other officials, and lastly your general character. Note: SBMHA Board Members cannot be used as references.

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* 35. Reference #2

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* 36. By submitting this application, do you consent the the following?

  Yes No
I acknowledge that I must successfully complete the RIS: Respect in Sport on-line clinic and that SBMHA expects that I incorporate the content of that clinic in my coaching philosophy.
I acknowledge and accept that should I be a successful candidate, SBMHA expects that I will adhere to the highest moral and ethical standards and that I will at all times refrain from any conduct that could reflect poorly on SBMHA or its membership.
I acknowledge and authorize SBMHA, Hockey Winnipeg, Hockey Manitoba and Hockey Canada to perform background checks, including, but not limited to Criminal Record and Vulnerable Sector Checks.
I acknowledge and accept that should I be a successful candidate, SBMHA has the authority to ask me questions concerning my player selections and I agree to cooperate fully by providing the basis for my player selections.
I acknowledge and accept that should I be the successful candidate for head coach, SBMHA has the unrestricted right to remove me as head coach at any time with or without cause.
I hereby claim that all the information submitted in this application is true, and that any discovery to the contrary will provide SBMHA with the unrestricted right to remove me as head coach at any time with or without cause and/or result in automatic disqualification of my application for this and any future opportunities within SBMHA.
DO NOT APPLY IF YOUR INTENT IS NOT GENUINE. ANY PERSON WHO APPLIES AND  IS AWARDED A TEAM, WHO THEN SUBSEQUENTLY DECLINES MAY LOSE THE OPPORTUNITY TO SERVE AS AN HEAD COACH OR ASSISTANT COACH FOR THE FOLLOWING TWO YEARS.
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