Select Team - Coach Application

Personal information
Name
Address
Home phone
Business phone
Cellular phone
Email address
Birthdate
Position applied for
Do you have a child in the age group you are applying for?
What is the child’s name is you answered yes above:
National Coaching Certification (Please indicate soccer related levels achieved)
NCCP No.
Theory Level –
Technical Level –
Coaching background with Nanaimo Youth Soccer
Year (most recent first)	Division	Team Name
Other certification, training and experience

References:

Please list three references from your past coaching experience.

Name

Home phone

Business phone

Name

Home phone

Business phone

Name

Home phone

Business phone

Please define your coaching philosophy:

Your thoughts on motivating your soccer players:

Your goals as a coach in this program: