NATIONAL COACHING STAFF APPLICATION FORM
The following application is to be completed and submitted to USA Boxing no later than
Wednesday, April 26, 2017. All applications must be typed and submitted with a copy of the
applicant’s resume and current passport in one of the following ways:
E-mail: Matt Johnson at [email protected]
Fax: (719) 866-2132 – Attn: Matt Johnson
Regular Mail: USA Boxing - Attn: Matt Johnson, 1 Olympic Plaza, Colorado Springs, CO
80909
PERSONAL INFORMATION
1. First Name
2. Last Name
Male
3. Gender
Female
4. Date of Birth (MM/DD/YYYY)
5. Nationality
6. Current Address
7. Phone Number(s)
Cell:
Work:
Home:
8. Email Address
9. Highest Level of Education
School Name:
Type of Program:
10. Profession
Company Name:
Job Title:
Part or Full Time
USA Boxing, Inc.
1 Olympic Plaza  Colorado Springs, Colorado 80909
PH: (719) 866-2300  FAX: (719) 866-2132  Website: www.usaboxing.org
NATIONAL COACHING STAFF APPLICATION FORM
11. Does your employer allow
you to leave work for extensive
periods of time?
1-2 weeks?
3-4 weeks?
4-6 weeks?
Yes
Yes
Yes
No
No
No
COACHING DETAILS
12. Active as coach since
USA Boxing Certification Level
Date of Last Course
13. Coaching Experience
AIBA Certification Level
Date of Last Course
14. Are you working as a coach
full time?
Athlete Name
15.
Top 5
highest
results
of your
athletes:
Ex: Joe Smith
16. What age group of athletes
do you most enjoy working
with ? Please rank the three
divisions with your preference.
No
Yes
Wt.
Class
114 lb.
Event
USA Boxing
National
Championships
Level:
Elite, Youth,
or Junior
Elite
Year
2017
Junior
Youth
Elite
USA Boxing, Inc.
1 Olympic Plaza  Colorado Springs, Colorado 80909
PH: (719) 866-2300  FAX: (719) 866-2132  Website: www.usaboxing.org
Result
Gold
NATIONAL COACHING STAFF APPLICATION FORM
FURTHER COMMENTS:
Please use the following space to explain why you are an ideal candidate to be considered for a
position on USA Boxing’s National Coaching Staff
Thank you!
USA Boxing, Inc.
1 Olympic Plaza  Colorado Springs, Colorado 80909
PH: (719) 866-2300  FAX: (719) 866-2132  Website: www.usaboxing.org