Coach Application

Prospective Extra Coaches, First of all, thank you for your interest in coaching a team in Region 34 Extra Program. Being an Extra Coach is a one season (August 2018 – March 2019) commitment to a team, and requires that we all dedicate our time and efforts for the same reason….the kids. With respect to the process, the deadline to submit your Extra Coach Application is March 23 rd, 2018. Verbal applications will not be recognized. You must allow the committee time to review all the applications. Please do not assume that you are automatically approved to be an Extra coach. Until you are formally approved and selected, you do not have an Extra team on which to offer anyone (players or Assistant Coaches) a position. Thank you again for your interest in our Extra Program. The Extra Program Committee, along with the Region 34 Executive Board, will make its decision and will notify all applicants as quickly as possible. COACH ELIGIBILITY At a minimum, Extra coaches (head or assistant) must:  Have a current Volunteer Application on file at eAYSO; 

Be an AYSO trained (or willing to be trained) and certified coach as specified in these Guidelines;  2005/2006 – Advanced Coach  2007/2008 – Intermediate Coach  2009/2010 – U12 Coach



Be Safe Haven certified;



Be in good standing with the Region, Area and/or Section and AYSO; and



Be approved by the Region board;

Those wanting to coach must fill out an application and submit it for approval. Coach selections may be limited by the number of teams formed for the 2018/2019 Extra Program in Region 34.

Page 1 of 3 Extra Program Coach Application

AYSO Region 34 Extra Program 2018-2019 COACH APPLICATION

PRE REQUISITES FOR SUBMMITTING an APPLICATION TO COACH      

Current AYSO Volunteer Application Form filed in eAYSO Compliance with training requirements for age of team being applied for per National and Region 34 Extra Program Guidelines AYSO Safe Haven Certification Completion of Concussion Training online at www.aysotraining.org. Completed Application Regional Board Approval

APPLICANT’S INFORMATION Full Name: ________________________________________________________________ Mailing Address: ___________________________________________________________ City, State, Zip ___________________________________________________________ E-mail Address: ____________________________________________________________ Best Phone #:

_________________________

TRAINING (Circle highest attained and year training completed) AYSO Coach: U6 USSF Coach:

E

U8

U10

D-State

U12

Intermediate Advanced

D- Nat’l

C

B

A

National Year:

# __________ Year: ________

Did you use the AYSO Reciprocity agreement for licensing?

Yes

AYSO Referee:

National

Year _________

Regional

Intermediate

Advanced

No _________

EXPERIENCE Experience Coaching/Training – AYSO Region: _____ Division: _____ Fall

All-Star

Select

Extra

Plus Year: ________

Region: _____ Division: _____ Fall

All-Star

Select

Extra

Plus Year: ________

Region: _____ Division: _____ Fall

All-Star

Select

Extra

Plus Year: ________

Total years in coaching in AYSO______ Experience Coaching/Training – Other Organizations (USYS, US Club, SAY, etc): Club: ___________________ Level: ______________ Years: _______ - _________ Club: ___________________ Level: ______________ Years: _______ - _________

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Gender and Birth Year being requested to coach in Extra (Circle) B2010

B2009

B2008

B2007

B2006

B2005

G2010

G2009

G2008

G2007

G2006

G2005

Additional experience you consider relevant to your application to coach an Extra team: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ (If you require more space, please attach additional paperwork to your application when submitted)

RETURN COMPLETED APPLICATION TO: Leanne Raad

e-mail to: [email protected]

Page 3 of 3 Extra Program Coach Application