Coach/Trainer Reimbursement Form (Peterborough Girls Hockey Association)
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Coach/Trainer Reimbursement Form
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Coach/Trainer Reimbursement Form
This form is for all Peterborough Girls Hockey Association REP and House League team staff for certification reimbursement. **** Please submit a new form for each course taken **** ONLY SUBMIT ONCE YOU HAVE PASSED THE COURSE **** Reimbursement will be made once you are rostered to a team or added to our volunteer list **** Reimbursement is for course fee only ****
REQUIRED ITEMS:
Coaches: Coach certification, Respect In Sport Activity Leader, Valid Police check/Declaration
(the coach certification required will vary depending on the level of hockey you are coaching)
Trainers: Trainer Certification, Respect In Sport Activity Leader, Valid Police check/Declaration
Managers: Respect In Sport Activity Leader, Valid Police check/Declaration
OWHA Site: www.owha.on.ca
Contact Information
First and Last Name
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Address
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Number / Street Name
City
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Postal Code
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A1B2C3
Contact Number
*
Example: ###-###-####
Email Address
*
Example:
[email protected]
Team Information
Which team are you requesting this for?
Select Your Team
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Select One...
REP - U9A
REP - U9B
REP - U11 AA
REP - U11 A
REP - U11 BB
REP - U13 AA
REP - U13 A
REP - U13 BB
REP - U13 B
REP - U15 AA
REP - U15 A
REP - U15 BB
REP - U15 B
REP - U18 AA
REP - U18 A
REP - U18 BB/B
HL - U7
HL - U9 Green
HL - U9 Maroon
HL - U18 DS
REP - Senior
HL - U11 Black
HL - U11 Silver
HL - U13 Blue
HL - U13 Maroon
HL - U15/U18 White
HL - U15/U18 Black
HL - U15/U18 Blue
HL - U15/U18 Maroon
HL - U15/U18 Green
HL - U15/U18 Teal
Position on Team
*
Select One...
Coach
Trainer
Manager
Coach, Trainer, Manager
Clinic Information
Enter Information for the clinic attended
Type
*
Select One...
COACH - DEVELOPMENT 1
COACH - INSTRUCTIONAL STREAM
COACH - PROFESSIONAL DEVELOPMENT
COACH 1 - INTRO TO COACH
COACH 2 - COACH LEVEL
HU - ONLINE Coach 1/2
TRAINER - HTCP Level 1
TRAINER - HTCP Level 1 Refresher
ALL - RESPECT IN SPORT-ACTIVITY LEADER
POLICE CHECK with VULNERABLE SECTOR SCREENING
Police check, Trainer, Coach, Respect In Sport
Fee
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Enter the amount of the fee for this certification
Clinic Location
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Clinic Date
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Attachment
Receipt & Certification Attachments
Please attach scanned copy of receipt
*
Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.
Please attach scanned copy of certitication
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Allowed extensions: .jpeg, .jpg, .png, .gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
Maximum # Files: 5. Maximum File Size: 4MB.
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