Coaches/Managers - Bingera Football Club

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Coaches/Managers

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Coaches's application forms

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                                              BINGERA FOOTBALL CLUB

                  Grounds – 108 Queen Street, North Bundaberg, QLD 4670
                                            secretary@bingerafootballclub.org.au

COACHING APPLICATION FORM - 2018

Name:________________________________________________________

Address:_______________________________________________________

Phone No:_______________________ Mobile:________________________

Email:_________________________________________________________

Age group applying for: 1st Preference____________2nd Preference______________
Would you be prepared to be assistant coach if you do not get your preferences – Y / N
Do you hold a current Coaching Certificate – Y / N
If yes what level of certificate is held: Level 1  2  3  4 __________________________
Blue Card Number_____________________________________________________
Indicate the last three (3) teams you coached and at which club.
1___________________________________________________________________
2___________________________________________________________________
3___________________________________________________________________

Please provide the names of three (3) Character References.
1____________________________________________________________________
2____________________________________________________________________
3____________________________________________________________________

To coach at the Bingera Football Club you will be required to operate under the Bingera Coach’s Roles & Responsibilities and comply with the requests of the Bingera Football Club Committee. You must accept that you are an ambassador for Football and the Bingera Football Club. If successful you will be required to sign a declaration statement indicating your agreement to abide by the Bingera Football Club’s Coach’s Roles & Responsibilities and By-laws.

Signature:_____________________Witness______________________Date____________




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