Coaches Corner

Name

First Name

Last Name

Date

Address

City

State/Province

Zip/Postal

Country

Cell Phone

Email

Coaching Experience (High school/college/recreational):

Playing Experience (High school/college/ recreational):

Other Experience (officiating, teaching, supervisory positions, etc):

Current work status (job title, company, how long at current position, etc):

References (list 2 references that we have permission to contact):

Name

Relationship to Applicant

Phone

Email

Name

Relationship to Applicant

Phone

Email

Coaching Philosophy (write a short paragraph stating your coaching philosophy for the age group you will be coaching):

Have you ever been convicted of a crime, including sex-related or abuse related offenses?

Yes

No

If yes, explain below

I have read all of the rules and regulations for GJ Blackout and understand them completely. By signing this application, I hereby verify that the information provided is true and correct and wish to be considered as a coach in this program. I also understand that a background check will be performed and passing this background check is a condition of being a coach in our program.

I agree

Name

First Name

Last Name

Signature

Clear

Date

Coaches Corner

Sponsors

GJ Blackout

Download the App!

Open to the Public