Coaching Application

First Name:
Last Name:
Date:
Address:
City:
State:
Email:
Home phone:
Work phone:
Cell Phone:
Fax

Age group and position applying for and why to you wish to coach?

Previous Coaching Experience:

Please explain your coaching philosophy and why you think that it would benefit the players and the NorthStar Club.

Please list any playing experience:

Have you read and do you agree with the NorthStar website Mission statement and Club philosophy

	Yes
	No

Have you ever been convicted or charged with a crime?

	Yes
	No

If yes please provide an explanation.

Please include (required) a min of 3 personal references… Name and phone numbers. In addition any and all supporting information, feed back letters, documentation that you feel would be beneficial in making this decision.

Name:
Phone:
Name:
Phone:
Name:
Phone:

Risk Mgmt #
Risk Mgmt Exp Date
State of Issue

By clicking "Accept" you agree to this application and will be subject to a background checks and reference checks. You understand, agree with and support the NorthStar philosophy.

Please fax a copy of your drivers license and your current Risk management card if available to 1.888.396.6269.

I accept