ATHLETIC COACH ASSIGNMENT RECOMMENDATION

ATHLETIC COACH ASSIGNMENT RECOMMENDATION
MT. DIABLO UNIFIED SCHOOL DISTRICT

1936 Carlotta Drive, Concord, California 94519-1397

Phone (925) 682-8000 ext. 4058

Fax (925) 676-4092
Complete and submit this form and the Athletic Director will automatically receive an email to approve. Once the prospective coach and Athletic Director complete the Athletic Coaching Recommendation, the appropriate HR staff will be notified.

All coaches must complete onboarding requirements and be fingerprinted.

Coaches are not allowed to coach or be present around student athletes until all paperwork, certificates, and clearances are complete.
Coach Legal First Name*
Coach Legal Last Name*
Coach Nickname
Are you a current or returning MDUSD employee?
New ProspectReturning coach for new seasonVolunteer
Please put your employee ID number (if known)
Email*
example@example.com
Cell Phone*
Home Phone
Home Address, City, State, Zip Code V2*
Home Address, City, State, Zip Code*
School Site*
Coaching Year*
VarsityJ.VFreshmanFROSH /SOPH
Season*
Sport you are coaching:*
Gender of the sport you are coaching:*
Recommended by (Athletic Director Name)*
Recommended by Email (Athletic Director)*
example@example.com
HeadAssistant
Recommended by Email (Athletic Director) 2
example@example.com
District FundedSelf FundedGate Funded (FROSH)Volunteer
By signing below, I understand that I must:

1. Have a current First Aid Card and CPR Card. (Completed in person, or through red cross)

2. Must show a current (within 60 days) clear TB test.

3. Complete the Coach Onboarding Checklist (PowerSchool Records)

4. Complete ALL required courses (NFHS)

5. Complete and be Cleared through District & DOJ Fingerprint Process (Done at orientation)
Prospective Coach Signature *

Clear
Date*

MonthDayYear
Date
**BELOW INFORMATION WILL BE COMPLETED BY THE SCHOOL SITE**
Athletic Director,

Please complete the following information.

Thank you,

- Human Resources
Phone/Ext
Format: (000) 000-0000.
Recommenders (Athletic Director) Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

ATHLETIC COACH ASSIGNMENT RECOMMENDATION

**BELOW INFORMATION WILL BE COMPLETED BY THE SCHOOL SITE**

BELOW INFORMATION WILL BE COMPLETED BY THE SCHOOL SITE