Mad River Youth Soccer League
MAD RIVER YOUTH SOCCER LEAGUE MAD RIVER UNITED Trainer Application Last Revised: 18 September 2015
A Trainer is a representative of our program at all times, and is expected to model the highest standards of fair play, good sportsmanship, and responsibility. The Trainer is expected to conduct his- or herself with integrity, honesty, and promote and maintain the reputation of Mad River Youth Soccer League and Mad River United.
Contact Information Please print Name: Street Address: Mailing Address (if different): City:
State:
Zip:
Mobile Phone:
Home Phone:
Work Phone:
Email Address:
Personal 1. Please outline your soccer coaching or training background and experience.
2. Please describe your playing background and experience.
3. Please describe any other youth sports involvement you have (coach, board member, referee, etc.):
4. What is the name of the last soccer organization you worked with?
Who was your Director of Coaching or supervisor? Please provide a name and contact phone number. 1
MAD RIVER YOUTH SOCCER LEAGUE MAD RIVER UNITED Trainer Application Last Revised: 18 September 2015
5. What is your highest coaching license level and granting association? 6. If you do not possess a coaching license would you be willing to obtain one? ☐ No ☐ Yes 7. Have you ever been convicting of a felony or had other issues which will result in a negative background check? If yes, please explain. ☐ No ☐ Yes
References Please provide three personal or professional references: Name:
Name:
Name:
Phone:
Phone:
Phone:
Email Address:
Email Address:
Email Address:
How do you know this
How do you know this
How do you know this
person?
person?
person?
Agreement and Signature By signing below, you are attesting to the following: I have read the Mad River United Team Handbook and Heading Guidelines If selected as a Mad River United Trainer I agree to abide by the MRYSL and Mad River United guidelines and policies, as well any and all policies established by the MRYSL Board of Directors and Mad River United (MRU) Committee. I will comply with all background check requirements.
ARCATA
Mail: P.O. Box 103, Arcata, CA 95518 Physical: 1309 11th St Ste 202 Arcata, California www.mrysl.net (707) 822-3333 BIG LAGOON BLUE LAKE FIELDBROOK HOOPA MANILA MCKINLEYVILLE SALYER SAMOA TRINIDAD WILLOW CREEK 2
MAD RIVER YOUTH SOCCER LEAGUE MAD RIVER UNITED Trainer Application Last Revised: 18 September 2015
I certify that the statements made on this application and (if included) my resume or additional documentation are true and correct, and that they contain no material omissions. __________________________________________________________ Signature Date
Application Directions Please scan and email this signed application and any supporting documentation to: Mad River United Director of Coaching:
Phillip Rouse - [email protected]
Mad River United Committee Chair:
Anthony Kahn – [email protected]
Mad River Youth Soccer League Board President: Tim Canning – [email protected] or mail or drop off this signed application and any supporting documentation to the MRYSL office (see footer for addresses).
ARCATA
Mail: P.O. Box 103, Arcata, CA 95518 Physical: 1309 11th St Ste 202 Arcata, California www.mrysl.net (707) 822-3333 BIG LAGOON BLUE LAKE FIELDBROOK HOOPA MANILA MCKINLEYVILLE SALYER SAMOA TRINIDAD WILLOW CREEK 3
A Trainer is a representative of our program at all times, and is expected to model the highest standards of fair play, good sportsmanship, and responsibility. The Trainer is expected to conduct his- or herself with integrity, honesty, and promote and maintain the reputation of Mad River Youth Soccer League and Mad River United.
Contact Information Please print Name: Street Address: Mailing Address (if different): City:
State:
Zip:
Mobile Phone:
Home Phone:
Work Phone:
Email Address:
Personal 1. Please outline your soccer coaching or training background and experience.
2. Please describe your playing background and experience.
3. Please describe any other youth sports involvement you have (coach, board member, referee, etc.):
4. What is the name of the last soccer organization you worked with?
Who was your Director of Coaching or supervisor? Please provide a name and contact phone number. 1
MAD RIVER YOUTH SOCCER LEAGUE MAD RIVER UNITED Trainer Application Last Revised: 18 September 2015
5. What is your highest coaching license level and granting association? 6. If you do not possess a coaching license would you be willing to obtain one? ☐ No ☐ Yes 7. Have you ever been convicting of a felony or had other issues which will result in a negative background check? If yes, please explain. ☐ No ☐ Yes
References Please provide three personal or professional references: Name:
Name:
Name:
Phone:
Phone:
Phone:
Email Address:
Email Address:
Email Address:
How do you know this
How do you know this
How do you know this
person?
person?
person?
Agreement and Signature By signing below, you are attesting to the following: I have read the Mad River United Team Handbook and Heading Guidelines If selected as a Mad River United Trainer I agree to abide by the MRYSL and Mad River United guidelines and policies, as well any and all policies established by the MRYSL Board of Directors and Mad River United (MRU) Committee. I will comply with all background check requirements.
ARCATA
Mail: P.O. Box 103, Arcata, CA 95518 Physical: 1309 11th St Ste 202 Arcata, California www.mrysl.net (707) 822-3333 BIG LAGOON BLUE LAKE FIELDBROOK HOOPA MANILA MCKINLEYVILLE SALYER SAMOA TRINIDAD WILLOW CREEK 2
MAD RIVER YOUTH SOCCER LEAGUE MAD RIVER UNITED Trainer Application Last Revised: 18 September 2015
I certify that the statements made on this application and (if included) my resume or additional documentation are true and correct, and that they contain no material omissions. __________________________________________________________ Signature Date
Application Directions Please scan and email this signed application and any supporting documentation to: Mad River United Director of Coaching:
Phillip Rouse - [email protected]
Mad River United Committee Chair:
Anthony Kahn – [email protected]
Mad River Youth Soccer League Board President: Tim Canning – [email protected] or mail or drop off this signed application and any supporting documentation to the MRYSL office (see footer for addresses).
ARCATA
Mail: P.O. Box 103, Arcata, CA 95518 Physical: 1309 11th St Ste 202 Arcata, California www.mrysl.net (707) 822-3333 BIG LAGOON BLUE LAKE FIELDBROOK HOOPA MANILA MCKINLEYVILLE SALYER SAMOA TRINIDAD WILLOW CREEK 3
