Coach Application

Once you have submitted your information, you will be contacted by our Coaching Director to finalise any additional details we require, if you have any questions, please send us an email at southernbears@uniqweb.net.

Either submit online or
print and fax to 9764 4506 or mail to P O Box 2048, Rowville 3178

Contact Information

Family Name
Given Names
Address
Telephone
Mobile
Email

Personal information

Male   Female

Date of Birth

Coaching Experience

No   Yes

If Yes, please give details

Level 1   Level 2

When (level 1)
Where (level 1)
When (level 2)
Where (level 2)

Preferences for coaching

	First Preference	Second Preference
Training Day (Mon-Thur)
Training Time (1hr blocks, between 5.30 - 10.30)
Training Venue (RCC - REC)
Team Gender (boys or girls)
Children’s name/team

General Comments