* 1. Name:

* 2. Sport :

* 3. NCCP Number:

* 4. Indicate your highest level of NCCP training/certification:

* 5. What is your highest level of coach experience?

* 7. Are you 16 years of age or older?

* 8. Are you currently an active coach member with your Provincial/Territorial Sport organization?

* 9. Please provide us with your email address so we may contact you with further information on the 2019 Aboriginal Apprentice Canada Games Apprenticeship Program.

* 10. Are you of Aboriginal ancestry as defined by the Aboriginal Sport Circle? (Anyone of First Nation (status and non-status Indian), Métis or Inuit ancestry)

* 11. Why do you want to be part of this program?

* 12. I acknowledge that I have read the following information regarding the program requirements:
Participation in the following two Professional Development (PD) workshops:
#1 April-May 2018
#2 November 8-10, 2018 – Sport Leadership Conference - Ottawa, ON
#3 Participation in the Canada Winter Games in Red Deer, AB – Feb 2019 (week 1 or week 2 depending on the sport calendar)
#4 Additional commitments to be determined by each province/territory and sport organization.

* 13. Thank you for your interest in the 2019 Aboriginal Apprentice Coach Canada Winter Games Apprenticeship Program!
You will be contacted by your Provincial/Territorial Coaching Representative.