CALIPATRIA UNIFIED SCHOOL DISTRICT 501 WEST MAIN STREET, CALIPATRIA, CA Application for Coaching

Transcription

1 CALIPATRIA UNIFIED SCHOOL DISTRICT 501 WEST MAIN STREET, CALIPATRIA, CA Application for Coaching Last Name First Name Middle Other Legal Name Used Address (Mailing and Physical if different) City, State, Zip Code Telephone Telephone Soc Sec No. Position(s) for which you are applying Do you have a valid California Driver's License? Have you previously worked for Calipatria Unified School District? Date Available for Employment School Site: Class/Type: If yes, please state when: Education and/or Experience History Please attach any qualifying certificates or transcripts and include a resume describing education, training or participation experience as needed. Dates Example: Name & Address of agency where education or experience Calipatria High School, Calipatria, California Describe education, training of participation Played football/basketball/baseball Personal References Name Address Telephone How long known I HEREBY CERTIFY that all statements made herein are true and correct to the best of my knowledge and AUTHORIZE investigation of all statements contained herein. I UNDERSTAND if I am hired, I will be required to submit verification of my legal right to work in the United States and submit to fingerprinting for criminal background Signature of Applicant Date

2 Calipatria Unified School District Certification for Temporary Athletic Coaches Qualifications For School Year Name: Address: Telephone Number(s): REQUIRED QUALIFICATIONS 1. Criminal Background Check No Conviction of Offenses Involving Moral Turpitude or Unfitness to Associate with Children (EC 44010, 44011, 44424, Serious Felony, Sex Offenses or Controlled Substance Offenses) All paid and volunteer coaches must have clearance through DOJ and FBI. Please check status of each applicant prior to starting assignment. 2. Examination for tuberculosis (Education Code 49406) All paid coaches must have tuberculosis assessment upon hire and every four (4) years thereafter. COMPETENCY REQUIREMENTS (5 CCR 5593): Information must be provided for at least one item in each box in Sections 3 through 6 below. Attached additional documentation as needed. 3. Care and Prevention of Athletic Injuries, Basic First Aid and Emergency Procedures A. Completion of a college level course in the care and prevention of athletic injuries and possession of a valid CPR card Course Name: Institution: Verification (Name Title Date) B. Valid sports injury certificate or first aid card and CPR card Sports Injury Certificate Exp. First Aid Card Exp. CPR Card Exp. 4. Coaching Techniques: Coaching Theory and Techniques in the Sport or Game Being Coached C. Valid Emergency Technician (EMT) I or II card D. Valid National or California Athletic Trainer s Assoc. Trainer s certificate E. Experience supervised by a qualified athletic trainer with valid CPR and First Aid cards. A. Completion of a college course in coaching theory and techniques B. Completion of District or County Office Inservice Program C. Prior Service as a Student Coach or Asst. Athletic Coach in the sport being coached D. Prior coaching in community youth athletic programs in the sport being coached EMP I or II Card Exp. ATC Certificate # Exp. Date Verification attached including name of trainer, dates of supervised experience and name of qualified trainer. Course Name: Institution: Inservice by: Name of Program: Sport(s): Name of Program: Sport(s):

3 Calipatria Unified School District Certification for Temporary Athletic Coaches Qualifications For School Year Name: Address: Telephone Number(s): REQUIRED QUALIFICATIONS 4. Coaching Techniques (continued) E. Prior participation in organized competitive athletics at high school level or above in sport being coached 5. Rules & Regulations Pertaining to the Sport or Game Being Coached, league rules, including Calif. Interscholastic Federation (CIF) regulations at the high school level Name of Sport(s): Course(s), Seminar(s): Prior Experience: Date(s) Name of Program: Sport(s): Other Evidence: 6. Child or Adolescent Psychology, whichever appropriate to grade level of the activity involved A. Completion of College Level Course in Child Psychology (Elementary School) or Adolescent or Sports Psychology (High School) B. Completion of Seminar or Workshop on Human Growth and Development of Youth C. Prior Active Involvement with Youth in School/Community Sports Program Course Title: Name of Institution: Course Title: Name of Institution: Sports Program: Period of Time/Dates: Waiver of Competency Requirements allowed if enrolled in appropriate training courses leading to acquisition of competency. 7. Competency Compliance Waiver Course Name(s) Anticipated Date(s) of Completion: Name of Supervising Coach:

4 Calipatria Unified School District Certification for Temporary Athletic Coaches Qualifications For School Year Name: Address: Telephone Number(s): REQUIRED QUALIFICATIONS 8. CODE OF ETHICAL CONDUCT Employees providing supervisory or instructional services in interscholastic athletic programs and activities shall: (5 CCR 5596) (a) Show respect for players, officials and other coaches. (b) Respect the integrity and judgment of game officials. (c) Establish and model fair play, sportsmanship, and proper conduct. (d) Establish player safety and welfare as the highest priority. (e) Provide proper supervision of students at all times. (f) Use discretion when providing constructive criticism and when reprimanding players. (g) Maintain consistency in requiring all players to adhere to the established rules and standards of the game to be played. (h) Properly instruct players in the safe use of equipment. (i) Avoid exerting undue influence on a pupil's decision to enroll in an athletic program at any public or private postsecondary educational institution. (j) Avoid exerting undue influence on pupils to take lighter academic course(s) in order to be eligible to participate in athletics. (k) Avoid suggesting, providing, or encouraging any athlete to use nonprescription drugs, anabolic steroids, or any substance to increase physical development or performance that is not approved by the United States Food and Drug Administration, Surgeon General of the United States or American Medical Association. (l) Avoid recruitment of athletes from other schools. (m) Follow the rules of behavior and the procedures for crowd control as established by the local board of education and the league in which the district participates. CERTIFICATION I hereby certify that the provisions of Education Code and California Code of Regulations Title have been met. I also agree to abide by the Code of Ethical Conduct as required by California Code of Regulations Title Signature Temporary Athletic Coach Date Signature Superintendent s Designee (Principal or Athletic Director) Date

5 Please keep this information for your reference No Conviction of Offenses Involving Moral Turpitude or Unfitness to Associate with Children (EC 44010, 44011, 44424, Serious Felony, Sex Offenses, Controlled Substance Offense) Education Code Sex Offense; School Employees "Sex offense," as used in Sections 44020, 44237, 44346, 44425, 44436, 44836, and 45123, means any one or more of the offenses listed below: (a) Any offense defined in Section 220, 261, 261.5, 262, 264.1, 266, 266j, 267, 285, 286, 288, 288a, 288.5, 289, 311.1, 311.2, 311.3, 311.4, , , 313.1, 647b, 647.6, or former Section 647a, subdivision (a), (b), (c), or (d) of Section 243.4, or subdivision (a) or (d) of Section 647 of the Penal Code. (b) Any offense defined in former subdivision (5) of former Section 647 of the Penal Code repealed by Chapter 560 of the Statutes of 1961, or any offense defined in former subdivision (2) of former Section 311 of the Penal Code repealed by Chapter 2147 of the Statutes of 1961, if the offense defined in those sections was committed prior to September 15, 1961, to the same extent that an offense committed prior to that date was a sex offense for the purposes of this section prior to September 15, (c) Any offense defined in Section 314 of the Penal Code committed on or after September 15, (d) Any offense defined in former subdivision (1) of former Section 311 of the Penal Code repealed by Chapter 2147 of the Statutes of 1961 committed on or after September 7, 1955, and prior to September 15, (e) Any offense involving lewd and lascivious conduct under Section 272 of the Penal Code committed on or after September 15, (f) Any offense involving lewd and lascivious conduct under former Section 702 of the Welfare and Institutions Code repealed by Chapter 1616 of the Statutes of 1961, if that offense was committed prior to September 15, 1961, to the same extent that an offense committed prior to that date was a sex offense for the purposes of this section prior to September 15, (g) Any offense defined in Section 286 or 288a of the Penal Code prior to the effective date of the amendment of either section enacted at the Regular Session of the Legislature committed prior to the effective date of the amendment. (h) Any attempt to commit any of the offenses specified in this section. (i) Any offense committed or attempted in any other state or against the laws of the United States which, if committed or attempted in this state, would have been punishable as one or more of the offenses specified in this section. (j) Any conviction for an offense resulting in the requirement to register as a sex offender pursuant to Section 290 of the Penal Code. (k) Commitment as a mentally disordered sex offender under former Article 1 (commencing with Section 6300) of Chapter 2 of Part 2 of the Welfare and Institutions Code, as repealed by Chapter 928 of the Statutes of Education Code Controlled Substance Offense "Controlled substance offense" as used in Sections 44346, 44425, 44436, 44836, and means any one or more of the following offenses: (a) Any offense in Sections to 11355, inclusive, 11361,11366, 11368,11377 to 11382, inclusive, and of the Health and Safety Code. (b) Any offense committed or attempted in any other state or against the laws. of the United States which, if committed or attempted in this state, would have been punished as one or more of the above-mentioned offenses. (c) Any offense committed under former Sections to 11503, inclusive, 11557, 11715, and of the Health and Safety Code. (d) Any attempt to commit any of the above-mentioned offenses. Education Code Conviction Of Certain Penal Code Sections Ground For Revocation (a) Upon the conviction of the holder of any credential issued by the State Board of Education or the Commission on Teacher Credentialing of a violation, or attempted violation, of a violent or serious felony as described in Section , or any one or more of Penal Code Sections 187 to 191, inclusive, 192 insofar as this section relates to voluntary manslaughter, 193, 194 to 217.1, inclusive, 220, 222, 244, 245, 261 to 267, inclusive, 273a, 273ab, 273d, 273f, 273g, 278, 285 to 288a, inclusive, 424, 425, 484 to 488, inclusive, insofar as these sections relate to felony convictions, 503 and 504, or of any offense involving lewd and lascivious conduct under Section 272 of the Penal Code, or any offense committed or attempted in any other state or against the laws of the United States which, if committed or attempted in this state, would have been punished as one or more of the offenses specified in this section, becoming final, the commission shall forthwith revoke the credential.

6 (b) Upon a plea of nolo contendere as a misdemeanor to one or more of the crimes set forth in subdivision (a), all credentials held by the respondent shall be suspended until a final disposition regarding those credentials is made by the commission. Any action that the commission is permitted to take following a conviction may be taken after the time for appeal has elapsed, or the judgment of conviction has been affirmed on appeal, or when an order granting probation is made suspending the imposition of sentence and the time for appeal has elapsed or the judgment of conviction has been affirmed on appeal, irrespective of a subsequent order under the provisions of Section of the Penal Code. (c) The commission shall revoke a credential issued to a person whose employment has been denied or terminated pursuant to Section (d) Notwithstanding subdivision (a), a credential shall not be revoked solely on the basis that the applicant or holder has been convicted of a violent or serious felony if the person has obtained a certificate of rehabilitation and pardon pursuant to Chapter 3.5 (commencing with Section ) of Title 6 of Part 3 of the Penal Code. Education Code Mandatory Leave of Absence Offense (a) For purposes of this section, "charged with a mandatory leave of absence offense" is defined to mean charged by complaint, information, or indictment filed in a court of competent jurisdiction with the commission of any sex offense as defined in Section 44010, or with the commission of any offense involving aiding or abetting the unlawful sale, use, or exchange to minors of controlled substances listed in Schedule I, II, or III, as contained in Section 11054, 11055, and of the Health and Safety Code, with the exception of marijuana, mescaline, peyote, or tetrahydrocannabinols. (b) For purposes of this section, "charged with an optional leave of absence offense" is defined to mean a charge by complaint, information, or indictment filed in a court of competent jurisdiction with the commission of any controlled substance offense as defined in Section or 87011, or a violation or attempted violation of Section 187 of the Penal Code, or Sections to 11361, inclusive, Section 11363, 11364, or of the Health and Safety Code, insofar as these sections relate to any controlled substances except marijuana, mescaline, peyote, or tetrahydrocannabinols. (c) For purposes of this section and Section , the term "school district" includes county offices of education. (d) (1) Whenever any certificated employee of a school district is charged with a mandatory leave of absence offense, as defined in subdivision (a), upon being informed that a charge has been filed, the governing board of the school district shall immediately place the employee on compulsory leave of absence. The duration of the leave of absence shall be until a time not more than 10 days after the date of entry of the judgment in the proceedings. No later than 10 days after receipt of the complaint, information, or indictment described by subdivision (a), the school district shall forward a copy to the Commission on Teacher Credentialing. (2) Upon receiving a copy of a complaint, information, or indictment described in subdivision (a) and forwarded by a school district, the Commission on Teacher Credentialing shall automatically suspend the employee's teaching or service credential. The duration of the suspension shall be until a time not more than 10 days after the date of entry of the judgment in the proceedings. (e) (1) Whenever any certificated employee of a school district is charged with an optional leave of absence offense as defined in subdivision (b), the governing board of the school district may immediately place the employee upon compulsory leave in accordance with the procedure in this section and Section If any certificated employee is charged with an offense deemed to fall into both the mandatory and the optional leave of absence categories, as defined in subdivisions (a) and (b), that offense shall be treated as a mandatory leave of absence offense for purposes of this section. No later than 10 days after receipt of the complaint, information, or indictment described by subdivision (a), the school district shall forward a copy to the Commission on Teacher Credentialing. (2) Upon receiving a copy of a complaint, information, or indictment described in subdivision (a) and forwarded by a school district, the Commission on Teacher Credentialing shall automatically suspend the employee's teaching or service credential. The duration of the suspension shall be until a time not more than 10 days after the date of entry of the judgment in the proceedings.