2024-25 Coach/Trainer Certification Rebate Form (Whitby Girls Hockey Association)

2024-25 Coach/Trainer Certification Rebate Form

The WGHA will pay a portion of costs for coach/trainer certifications and Respect in Sport Activity Leader course. WGHA does not reimburse for Criminal Record Checks (VSC).

Personal Information

Please ensure all contact information is current. This information will be used to mail reimbursement cheques.

First Name^*

Required

Last Name^*

Required

Street Address^*

Required

City^*

Required

Postal Code^*

Required

Primary Contact Telephone Number^*

Required

###-###-####

Email Address^*

Required

An email confirming receipt of your submission will be sent to this address.

Team Information

I am currently a member and/or support staff of the following team:

Division and Team Number ^*

Required

Example: HL U7 (Team 1), U13 AA etc.

Course Information

Clinic Type you completed^*

Required

Actual Clinic Date^*

Required

Example: October 20, 2022

Clinic Location^*

Required

Example: Online or Whitby

Cost^*

Required

Method of Payment^*

Cash
Cheque
Credit Card

Required

Please attach a copy of your paid receipt for the clinic^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
Maximum # Files: 1. Maximum File Size: 4MB.

Your application will NOT be considered without this information attached.

2024-25 Coach/Trainer Certification Rebate Form (Whitby Girls Hockey Association)

Personal Information

Team Information

Course Information

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