
Mite Prep Mites Squirt PeeWee Bantam Girls High School

2011-2012 LHA Coaching Application

Submission Deadline for the 2011-2012 season is July 31st.

If you are interested in coaching an LHA team, please complete the following form.

What levels are you interested in coaching as HEAD COACH (can choose more than one if desired)?		Jr Gold/U16 Bantam Peewee Squirt Girls U14 Girls U12 Girls U10 Mite Girls U8 Mite Prep
What levels are you interested in coaching as ASSISTANT COACH (can choose more than one if desired)?		Jr Gold/U16 Bantam Peewee Squirt Girls U14 Girls U12 Girls U10 Mite Girls U8 Mite Prep
What area are you?		Lakeville North Lakeville South N/A
What division do you expect your child to play at (Mite/U8 levels)?		4 3 2 1 N/A

Name
Address
City
Zip Code
Preferred Phone Number
Email Address
Birthdate

USA Hockey C.E.P. Level		Level 1 Level 2 Level 3 Level 4 Level 5 Not certified
CEP Coach Card #
CEP Level expiration date

Have you ever been subject to Association or League disciplinary action?		Yes No
If yes, explain
		If you would prefer to answer the following questions by email, send resume to headcoach@lakevillehockey.org
Coaching experience		Please limit to 250 words
Coaching philosophy		Please limit to 250 words
Playing experience		Please limit to 250 words
In accordance with MN Hockey District 8 policy, all LHA coaches must be Level appropriate certified with USA Hockey by 10/01/11, and have an expiration date of 2012 or later. Acknowledge that you will comply with this policy:		Yes

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