Head Coaching Application
Fill out completely & return this application & CORI form by January 11, 2009 (7:00 PM)
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PLEASE PRINT
I.) Name  / Address___________________________________________________________
City  / State /  Phone     ________________________________________________________

II.) USA Hockey Patches (Circle the patch(es) and provide year "patched")
Note: All head coaches, assistant coaches, and "on-bench" teams managers must be patched to the proper level
according to Mass Hockey for the 10-11 season prior to 12/31/10
a.) Initiation ______ (all 1st year coaches) b.) Associate ______ (all 1st year coaches above Imites)
c.) Intermediate ______ (all 2nd year head coaches or Squirt level & up)  d.) Advanced_____
e.) NOT PATCHED

III.) 1st Choice: (This choice will be the voted on by the Board)
Age Division: U14    U19   Midget     Bantam    PeeWee    Squirt     Mite     Instructional Mite
Team: "1"     "2"    "3"   "4"   "5"    Valley Buzzer 1     Valley Buzzer 2

IV.) 2nd Choice: (2nd choice will be voted on only after 1st Choice candidates have been eliminated )
Age Division: U14   U19  Midget     Bantam    PeeWee    Squirt     Mite     Instructional Mite
Team: "1"     "2"    "3"   "4"   "5"    Valley Buzzer 1     Valley Buzzer 2

V.) Playing & Coaching Background (attach Hockey resume, if available)
Youth Hockey: _______________________________________________________

High School:________________________________________________________

College: ___________________________________________________________

Other:_____________________________________________________________


VI.) What teams have you coached in the past (any sport / any association )
______________________________________________________________________________
______________________________________________________________________________

VI.) What day / time do you request for practice (decided by coach’s seniority, division, and team level)
Weds - Thurs - Fri for all teams , except Instructional Mites.
Monday & Saturday sessions are pre-assigned.

Mon Wed Thurs Friday Saturday
5:20 PM -
Association
Team Skills		 5:20 PM   5:20 PM 8:20 AM:
Imite Practice
      5:40 PM 9:30 AM:
Cross Ice
6:30 PM -
Association
Team Skills		 6:30 PM 6:30 PM    
  6:50 PM      


Wednesday                          Thursday                       Friday    (subject to change by Hockeytown
5:20 PM                                                                      5:20 PM 
                                                                                     5:40 PM 
6:30 PM                                 6:30 PM              
6:50 PM

Monday's 5:20 PM & 6:30 PM are team skills.
Saturday 8:20 AM is Imite Practice
Sat 9:30 AM is Cross-Ice