Application General Information I am 18 years or older. First Name (required) Last Name (required) Address (required) Apt / Bldg / Suite # City (required) Zip (required) Phone (required) Your Email (required) Shirt Size ---SMMEDLGXLXXL Qualifications Have you coached competitive basketball? ---NoYes If Yes, how many years Have you played competitive basketball? ---NoYes If Yes, how many years Have you officiated competitive basketball? ---NoYes If Yes, how many years Have you had any formal training? ---NoYes If Yes, training name and date Desired Position ---Head CoachAssistant CoachOther If Other, how would you like to help? Would you prefer to coach boys or girls? ---BoysGirlsNo Preference Desired Age Group (12 - 16 ) 12 13 14 15 16 Why do you want to coach? Have you been involved in any other sports? Have you ever been refused participation in any sports program? ---NoYes If Refused, why? I have read and agree to the program Code of Ethics.