This form is intended to collect information regarding those interested in coaching a Spring/Summer sport for Farmville Parks and Recreation. When possible responses will be used to confirm coaching assignments prior to registration closing so that families and coaches can plan accordingly.

Please complete this survey even if you noted an interested on your child's Spring sports registration form. Completion of this survey does not guarantee placement as a coach; all coaches must have a background check on file conducted by the Town of Farmville within the past two years. For more information and updates on coaching assignments contact Christopher Horrigan, Parks and Recreation Director, at chorrigan@farmvillenc.gov

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* 1. Coaches Name

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* 2. Sport(s) you are interested in coaching. Select all that apply. (Dates below include practices and games and are subject to change)

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* 3. Do you have previous experience coaching or playing the sport(s) you wish to coach.

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* 4. Are you the parent/guardian/relative of a child participating in the league you wish to coach?

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* 5. Barring special circumstances can you commit to leading a weekly practice and attending all games?

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* 6. Coach's phone number

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