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Coach Interest Form

Thank you for your interest in coaching with MAD Basketball Academy! Please complete the form below to apply for a volunteer coaching position.

Birthday
Month
Day
Year

Coaching Interest

What age group are you interested in coaching?
High School (15U-17U) – Must be at least 21 years old
Middle School (12U-14U) – Must be at least 18 years old
Are you currently coaching with any other basketball organization?
Yes
No

Certification & Eligibility

Do you have a USA Basketball Gold License?
Yes
No. In the process of obtaining.
Other
Expiration Date (if Yes)
Month
Day
Year
Are you NCAA Certified?
Yes
No. In the process of obtaining.
Expiration Date (if Yes)
Month
Day
Year
Do you have a current Red Cross First Aid/CPR Certification?
Yes
No. In the process of obtaining.
Expiration Date (if Yes)
Month
Day
Year
Are you willing to travel with the team and share a hotel room with fellow coaches if necessary?
Yes
No

Background Check & References

Have you ever been convicted of a felony or any crime involving minors?
No
Yes

Please provide two references (Name, Phone, and Relationship to You):

Agreement & Signature

By submitting this application, I acknowledge that coaching with MAD Basketball Academy is a volunteer position. I confirm that all information provided is accurate and agree to abide by the academy’s coaching policies and requirements.

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