Roger Neilson’s Coaching Clinic
Development 2 Clinic Application
This is a fill-able form – simply tab to each shaded area and type in information.
When complete save to your computer, print a copy to submit with your Application Package
Application Package Summary
Please confirm that the following criteria have been met and the appropriate items are included in your Application package:
Applicant holds Development 1 certification and is an active coach at the Peewee Rep Level or above
Applicant must be registered for the Roger Neilson's Coaches' Clinic to take advantage of the special pricing
Completed NCCP Development 2 Application (this document)
*** Submit this completed application via email to the attention of Mike Shiner - mshiner@rogerneilsonshockey.com
Applicant Information
Name
Address
Phone Number Email Address
Current Team Level & Category
Level of Certification Date of Expiry
Hockey Background
YEAR TEAM/CATEGORY ROLE
References
NAME POSITION EMAIL
Attachments
Please check box if you have included additional information regarding your coaching profile & hockey experience.
Please feel free to attach any other relevant information to this application form.