Coaching Application

Name		Phone
Address		Email
City/State		Date of Birth
Zip

Which age are you interested in coaching?

Which group would you prefer to coach?

Is there a particular team you are interested in?
If Yes, which one?:
If this team is not available are you interested in coaching another team in the appropriate age grouping?

Select the coaching license you currently hold as required by District VI?

Are you a certified Referee?

Have you played organized soccer?
If yes, years played:
How many years have you been coaching?

What do you see as an appropriate coaching stipend for your services per month?

Describe your coaching experience and what your specific qualifications are for the age group for which you are applying:

Have you ever been suspended from coaching or placed on probation?
If yes, please explain why:

Privacy Information: This information is confidential and will only be shared with El Dorado United Board Members for decision making purposes. If you have any questions, please contact the EDUCC president.