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* 1. Name:

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* 2. Hockey Canada Registry Number

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* 3. Birthdate

Date

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* 4. Best phone number to reach you:

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* 5. Best email to reach you:

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* 6. Have you Coached for FMMHA before

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* 7. What position are you Interested in?  please check all that apply

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* 8. Are you applying to coach as a non parent Coach?

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* 9. Please verify that your coaching credentials are Current and enter the latest date you took each course - you can find this information on your Hockey Canada account. 

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* 10. Describe your comfort level with accepting feedback, advice or criticism as well as your preference between being collaborative with other coaches and mentors,  versus working alone.

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* 11. Based on your work schedule and other commitments, how often will you make it to games, practices and other team commitments?

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* 12. Please briefly outline your coaching philosophy:

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* 13. Please describe what tools and support FMMHA can provide to help you be a successful coach. 

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* 14. Please Check off the following to confirm you have read and agree with FMMHA policies and Directives:

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