Fields marked with an asterisk (*) must be filled out before submitting.

Name *
Email *
Phone *
Home Address *
Current School (if applicable) *
University Address (if applicable)
Age *
How were you referred to SixFifty? *
For which program are you applying? * After School Classes

Indoor Box Leagues

Travel Teams
If hired, what date can you begin coaching? *
What days (Sun-Sat) are you available to coach? * Sun






Please list hours that you\’re available to work on the above days: *
High School Name *
In what year did you graduate (if applicable)
Please list name, address, & phone number of current or most recent employer *
May we contact your employer? *
Please list 3 references, name and phone # *
Please share your motivation for coaching and what skills, qualities, and expertise you can bring to the program: *
Please list any experience you’ve had coaching, teaching, or working with young people. *
Please list a brief coaches bio, including your playing/coaching experience
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company. Yes

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.

I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation Yes


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