Safety Guidelines for Secondary Interschool Athletics in Alberta

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5. What are the three primary goals that you are trying to achieve as a coach?
1._______________________________________________________________________________
2._______________________________________________________________________________
3._______________________________________________________________________________
6. Have you ever been convicted of any offense under the Criminal Code of Canada for which a pardon
has not been granted? Yes No
If yes, please explain._______________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
7. Do you understand/support the principles of the “fair play” philosophy in athletics?
Yes No _____
Explain how you would apply these principles to your coaching role.
________________________________________________________________________________
________________________________________________________________________________
8. How would you set standards of behaviour for the student athletes you coach?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
9. Please list two references associated with previous coaching experience.
Name (Not a Relative) Position Phone Number
This information is collected pursuant to the (name of School Board)’s role as employer as set out in the School Act. The
information is collected for employment and human resource planning purposes and is within the guidelines set out in the
Freedom of Information & Protection of Privacy Act. References listed on this form will be contacted for information with
respect to your suitability as a volunteer coach of (name of School Board) student athletes. By signing below, you authorize
the school board named above to conduct a security check with the proper authorities.
Signature of Applicant:________________________________________ Date:___________________
Signature of Principal/Designate:________________________________ Date:___________________
OFFICE USE ONLY
References checked. Yes No
By Signature of Principal/Designate:_____________________________________________________
Notes:______________________________________________________________________________
___________________________________________________________________________________
Application accepted ; not accepted
Orientation session completed. YES No Date:_________________________________________
Signature of Principal/Designate: ________________________________________________________
Date: __________________________________
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Safety Guidelines for Secondary Interschool Athletics in Alberta - February 2012