Volunteer Coaching Application

1. Personal Information

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* 1. Contact Information.

Name: *

Mailing Address: *

City/Town: *

State: *

ZIP: *

Cell Phone:

Home Phone: *

Email Address: *

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* 2. What sports are you interested in volunteer coaching?

Basketball

Baseball

Softball

Soccer

Field Hockey

NFL Flag Football

Youth Cheerleading

Other (please specify)

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* 3. What level(s) are you interested in coaching? (Pre-K K-2nd Grade, 3rd/4th Grade, 5th/6th Grade)

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* 4. Employment Information

Occupation:

Current Employer:

Education Level:

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* 5. Why are you interested in coaching?

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* 6. List your experience. (coaching, youth programs, working with children)

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* 7. How would you describe yourself as a youth sports coach?

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* 8. How would you describe your coaching philosophy? (Ex. having fun, winning, discipline, teamwork)

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* 9. Skills and Interests specific to this position.

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* 10. Certifications (CPR, Coaches Training, Concussion Training, etc.)

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* 11. Personal Reference 1

Name

Phone

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* 12. Personal Reference 2

Name

Phone

➢ The information I have provided may be verified, and I give permission to the Hartford Parks and Recreation Department to make inquiry of others concerning my suitability to act as a Hartford Parks and Recreation Department Volunteer.
➢ In the course of volunteering, I may be dealing with confidential information and I agree to keep said information in the strictest of confidence.
➢ The relationship between the Hartford Parks and Recreation Department and volunteers is an “at will” arrangement that may be terminated at any time without cause.
➢ I grant the Hartford Parks and Recreation Department to use my likeness, voice and words on TV, radio, film or in any form to promote activities of the Hartford Parks and Recreation Department.

I affirm that I have read the above and that the information I have given on this application is true and complete.