Position: Junior coach _______Assistant Coach________

Date____________________ Date received______________________

Name________________________________________________________________

Address______________________________________________________________

Birthdate_______________________ Phone #____________________________

Parents’ Name___________________________________________________________

Swimming Experience: ____________________________________________________

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Experience working with young children:______________________________________

______________________________________________________________________

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Why do you want this job?__________________________________________________

_______________________________________________________________________

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Are you trained in First Aid? ______exp.date_____CPR? _____exp. date_______

List any activities and/or vacations that would hinder you from making every

practice and meet:___________________________________________________________________

_______________________________________________________________________

I have read the job description. I would like to be considered for a

position of _________________ for the Hanarry Hurricanes.

Applicant Signature: __________________________________________________

I have read the job description. I would like for my child to be considered

for a position of _____________________ for the Hanarry Hurricanes.

Parent signature:_______________________________________________________