VIENNA YOUTH SOCCER, INC.

 

ALL STAR COACH APPLICATION

 

 

Date________________________

 

 

Name_________________________________________________________________________

 

 

Address_______________________________________________________________________

 

 

Age group you would like to coach_________________Girls_______Boys________

 

 

Home Phone____________Cell Phone ____________ Work Phone____________E-mail______________

 

 

How many seasons have you been a head coach or assistant coach with VYS?

 

Head Coach_____________________ Assistant Coach___________________

 

 

How many VYS All Star Teams have you been a Head Coach?_________Assistant Coach?_________

 

 

Are you active in any other areas of VYS other than coaching?  _______Yes  ______ No

 

 

If yes, please list areas:____________________________________________________________

 

 

Do you have any playing experience?  _______Yes  ________No     If yes, please explain:

 

 

________________________________________________________________________________

 

 

Are you a Referee?  ____Yes  ____No    Are you currently a certified referee? ____ Yes ____ No

 

 

In the last three years have you been carded for your behavior on the field? _____ Yes _____No

 

If yes, give a brief explanation:_______________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

 

 

I hereby certify that the above information is true and correct and that if I am chosen as the All Star Coach

 

I will abide by all rules and regulations of Vienna Youth Soccer, Inc., and the tournament in which I will be

 

participating.

 

 

____________________________________________                       ___________________________

 

Signature                                                                                               Date

 

 

Please use the back of the application to add additional information or comments.

 

 

Mail Application to:   Mary Nunley  12805 Gatepost Court   Oak Hill, VA 20171