FVLHS Application for Coaching

Personal Information

First Name *

Last Name *

Home Phone Number *

Work Phone Number *

Mobile Phone Number *

Email Address *

Confirm Email Address *

Home Address *

City *

State *

Zip Code *

Home Congregation *

Congregation's Street Address *

Congregation's City *

Congregation's Zip Code *

Current Employment Information

Full-Time Occupation *

Employer *

Direct Supervisor's Name *

Employer Phone Number *

Normal Working Hours *

Education

What is your education? Please enter N/A in fields that do not apply *

	Name & Location	Years	Grade Level and/or Degree
High School	Name & Location	Years	Grade Level and/or Degree
College or University	Name & Location	Years	Grade Level and/or Degree
Specialized Training, Trade School, etc.	Name & Location	Years	Grade Level and/or Degree
Other Education	Name & Location	Years	Grade Level and/or Degree

Coaching Interest

List the FVL sport you wish to coach. *

Athletic Experience & Expertise

List the organized interscholastic sports in which you participated, beginning in 10th grade.

Click the + sign to add more lines.

What is your coaching experience? *

	Sport	Team/Level	Years	Responsibility
1	Sport	Team/Level	Years	Responsibility
2	Sport	Team/Level	Years	Responsibility
3	Sport	Team/Level	Years	Responsibility

Please rate yourself in the following coaching abilities.

Leadership Qualities *

4 (strong)

1(weak)

Knowledge of Sports Skills *

4 (strong)

1(weak)

Ability to Teach *

4 (strong)

1(weak)

Rapport With Athletes *

4 (strong)

1(weak)

Energy Level *

4 (strong)

1(weak)

Role Model for Young People *

4 (strong)

1(weak)

Emotional Control Under Pressure *

4 (strong)

1(weak)

Please explain why you are interested in coaching at FVL. *

Are you willing to donate your time, or do you need reimbursement? FVL may give a small gift of thank you. *

I am willing to donate my time

I need reimbursement

Reference (Pastor)

1 - Name *

1 - Reference Address *

1 - City *

1 - State *

1 - Zip Code *

1 - Email Address *

1 - Phone Number *

Reference (Co-worker or Coach)

2 - Name *

2 - Reference Address

2 - City

2 - State

2 - Zip Code

2 - Email Address *

2 - Phone Number *

Reference (Sports Official or Opposing Coach)

3 - Name *

3 - Title

3 - Reference Company

3 - Reference Address

3 - City

3 - State

3 - Zip Code

3 - Email Address

3 - Phone Number

Letter of Certification (required by FVL Board of Regents)

Please choose one from below. *

I certify that I have never been charged and convicted of sexual exploitation, sexual harassment, sexual abuse, sexual assault, crime of violence, or sale, use, or possession of illegal substances.

An allegation of the aforementioned was filed, and I was cleared of all wrongdoing

An allegation of above mentioned has been made; it is presently under investigation

Please mark one of the below statements. *

I certify that I have never been charged and convicted of a felony.

I have been convicted of a felony.

I affirm that the information included on this form is true and complete.
My Signature (please type below) *

Today's Date * +

Coaching Requirement

If this is a WIAA coaching position, the WIAA requires all coaches to either be licensed to teach in the state of Wisconsin or employed as full-time instructors in a school. CNLT’s (coaches not licensed to teach) may coach for one year only. CNLT’s passing the “Fundamentals of Coaching” and “First Aid for Coaches” courses will be certified to coach beyond one year. Courses are online at www.NFHS.org (FVL will reimburse your course expenses upon course completion.)

Date Form Submitted * +

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Head Freshman	Assistant Freshman