To: - Nassau BOCES



PATHWAY I COVER SHEET

TEMPORARY COACHING LICENSE / PROFESSIONAL COACHING CERTIFICATE

Addendum to online application - Please complete this form and return to the Section VIII office with copies of

all required paperwork attached. Materials submitted without this form CANNOT be processed.

| | | |SSN: | |

|Name: | | | | |

|Address: | |

|Phone: | | |E-mail: | |

|District: | |Sport: | |Season: | |

I have completed an online

application for a: (check one)

| |Temporary Coaching License * |

| |Temporary Coaching License (renewal) * |

| |Professional Coaching Certificate |

| |Professional Coaching Certificate (renewal) |

|I am submitting the following to complete my online application: (check all that apply) |

|Requirements for first-time coaching applicants (initial application) |

| |First Aid (must be updated every three years) |

| |CPR (must be updated every two years) |

| |Completion of Identification and Reporting of Child Abuse Certification |

| |Completion of School Violence Prevention and Intervention (SAVE) Certification |

| |DASA Training (must be on file for all applicants, eff. 1/14) |

| |Fingerprint Clearance |

| | |

|Requirements for second-year coaches (first renewal) |

| |Valid First Aid and CPR |

| | |

|Requirements for third-year coaches (second renewal) |

| |Valid First Aid and CPR |

| |Completion of Philosophy, Principles and Organizations of Athletics in Education |

| | |

|Required before the fifth year of coaching—can be taken anytime within the process |

| |Completion of Health Sciences Applied to Coaching |

| |Completion of Theory and Techniques (of specific sport) |

| | |

|Professional Coaching Certificate (good for three years; sport-specific) |

| |Valid First Aid and CPR |

| |Completion of all required coursework |

| |A minimum of three years coaching experience in a specific sport in a NYS athletic program (three TCLs) |

| |Copies of satisfactory evaluations for the past three years of coaching (for all PCC applications, eff. 11/13) |

COACHES - please complete, attach documentation and return to your Athletic Director’s office

ATHLETIC OFFICES – please have the Superintendent’s statement completed and submit entire packet to:

Karen Wohlrab ● Sec. VIII Interscholastic Athletics ● Nassau BOCES Admin. Center

71 Clinton Road ● Garden City, NY 11530

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SEC. VIII Office Use ONLY

* Pࠀࠁࠋࠖࠗ࠘ࡗ࡝࡟ࡸࢇࣇࣈࣩ࣋ࣧࣨ࣪एकगणत���웒ꞵ躙莙灸硢卞䁋䁢幋ᔔ赨㰨ᘀ蹨彯伀ъ儀ъᘎ蹨彯伀ъ儀ъᔔഏᘀ蹨彯伀ъ儀ъᘆ蹨彯ᔛ㡨㘯ᘀ蹨彯㔀脈䩏[?]䩑[?]䩞[?]ᘎ逌伀ъ儀ъᔔ摏ᘀ蹨彯伀ъ儀ъᔔ逌ᘀ逌伀ъ儀ъᘕ逌㔀脈䩏[?]䩑[?]䩞[?]ᔛ煨舟ᘀ逌㔀脈䩏[?]䩑[?]䩞[?]ᔛ煨舟ᘀ蹨彯㔀脈䩏[?]䩑[?]䩞[?]ᔠ潨䉪ᘀ潨䉪䌀၊伀͊儀͊帀Ɋ愀၊ᘖ汨섨䌀᱊伀͊儀͊帀Ɋᘖ㡨㘯䌀᱊伀͊儀͊lease check this box to indicate that your Dist. Superintendent has completed the Superintendent’s statement (for temporary coaching license ONLY). Submission of the packet without the statement will result in the return of your documents and delay the processing of the application.

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