Coaching Personnel Data Sheet Template
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12016-2017
COACHING PERSONNEL DATA SHEET
NHCS Employee
Non-Faculty Volunteer Coach
Non-Faculty Coach
(No Supplement) Applicant must complete
(Receives Supplement)
Level II Volunteer Portal
Name____________
_______________________________
Last
First
Middle
Home Address _________________________________________________
City _________________________________________
Zip __________
Home # _____________________________
Date of Birth_____________
Cell#________________________________
Name of employer ______________________ Work Phone #______
____
Your email address _____________________________________________
Sport #1
School you are coaching _________________________________________
I will coach
Boys and/or
Girls
_______________________ _________________
List sport
Date sport starts: _________________
Date sport ends: _____________
Head Varsity
Asst. Varsity
Head JV Coach
Asst. JV Coach
Sport #2
School you are coaching _________________________________________
I will coach
Boys and/or
Girls______________________ ___________
List sport
Date sport starts: ________________
Date sport ends:______________
Head Varsity
Asst. Varsity
Head JV Coach
Asst. JV Coach
Will you be required to drive a school activity bus?
No
Yes CDL #______________
Expiration date__________
Will you receive a supplement?
No
Yes
Please email to
ann.carpenter@nhcs.net
or fax to 910-254-4471
1.17.17
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