*1.What is your contact information?(Required.)

Name

Address

City/Town

Province

Postal Code

Email Address

Phone Number

*2.Returning Coach?(Required.)

Yes

No

*3.What are your coaching qualifications/certifications? Please check all you have completed.(Required.)

None yet.(Don't worry we all start somewhere!)

Active Start

Fundamentals

Learn to Train

Soccer For Life

C License

B License

A License

Respect in Sport (Soccer)

Make Ethical Decisions (MED)

Making Headway in Sport (Soccer)

Other (please specify)

4.Do you have a current Police Record Check for the Vulnerable Sector or willing to obtain one?  (if it expires before Oct. 1, 2024 you will need a new one)

Yes

No

5.Do you have current First Aid Certification?  Please provide details.

6.Do you have other relevant experience you would like to bring our attention to?

7.What program would you like to coach this year? (check one or both)

Boys

Girls

Women

Men

8.What program would you like to coach in this summer?

Any Program

Not sure. I would like more information.

Grassroots Development (U8 to U13)

Grassroots Competitive (U8 to U13)

Youth Recreational (U14 to U18)

Youth Competitive (U14 to U18)

9.Are you a parent coach?  (Have a son/daughter on the team you would like to coach)

Yes

No