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Application for Coaching Assignment
Date ______________________
Name __________________________________ Phone
Number ______________
Address/City/Zip
____________________________________________________
Social Security
_____________________________________
Position Sought
___________________________ Level
____________________
Sport
Have you ever been convicted of a felony,
misdemeanor or any offense other than a minor
traffic violation?
Yes _______ No ________
Educational
Background
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School |
Date of Graduation |
Degree |
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High School |
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Teacher Certification: Yes_____
No_____ Subject
Area____________________
Athletic Experience
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Sport |
Level |
Years |
Organization |
Player or Coach |
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Present Experience
Occupation
_____________________________________________________
Name of Supervisor
_______________________________________________
Address ___________________________ Phone
Number ________________
References
Please return to:
Larry Gillooley
Director of Physical Education, Athletics &
Health
Niskayuna High School
1626 Balltown Road
Niskayuna, NY 12309 |
