PHMFA Football Coach Application

All PHMFA Coaches must turn in a Child Background Clearance prior to the Start of the Season

First name*

Last name*

Email*

Phone*

Are you a Penn Hills Resident*

Yes

Have you turned in a 2025 Child Abuse History Certification (CY113)?*

Yes

Patch Control#

Do you have/plan to have a Child Playing for the PHMFA this season?*

Yes

Member/Player/Cheerleader Name

Team

Member/Player/Cheerleader Name

Team

What PHMFA Team would you Like to Coach on?*

Scouts Football (ages 4-6)

Braves Football (ages 7 & 8)

Indians Football (ages 9 & 10)

Bantams Football (ages 11 -13)

What Position are you seeking*

Head Coach

Assistant Head Coach

Offensive Coordinator

Defensive Coordinator

Line Coach

Offensive Backs Coach

Defensive Backs Coach

Special Teams Coach

Trainer

Equipment manager

Heckler

Have you ever Coached at the PHMFA before?*

Yes

Do you have prior Coaching Experience Outside the PHMFA*

Yes

If Yes, Please list past organizations/teams you have coached

Do you have any prior experience serving in Youth Sports or Child Care?*

Yes

Reference Name

Reference Phone

List some qualification you feel are applicable.

PA Background Clearences

Penn Hills Midget Football Association

Practice Field
Mason Murray Field Friendship Park
Verona, PA 15147

Office/Equipment Room
William McKinley Center
1110 Center Ave
Verona, PA 15147

Main Office
phmfa@gmail.com
Tel: 412-337-4557

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