SHARONSPRINGS ATHLETIC ASSOCIATION

2017 Travel Coaches Application

(Every applicant must complete all sections)

Section I - Personal Information

Full Name:
Mailing Address:
Employer:
Work Mailing Address:
BEST CONTACT PHONE: / Home Phone:
Cell Phone: / Work Phone:
Email Address:
This our primary source of communication.
NYSCA MEMBER NUMBER:
Please indicate your member number for 2015 renewal. All others must attend NYSCA certification. NO EXCEPTIONS
Age Group Requested:
Assistant or Head Coach Name:
(one head and one assistant coach per team) / Position Requested
Please indicate any other sport or age group you are applying for more than one sport or age group. (Separate applications must be sent to Travel Commissioner)

Section II - Previous Experience

Number of years as an SSAA head coach: 0
Date(s) & Age group(s):
Year / Team / Age Group
Number of years as an SSAA assistant coach: 0
Date(s) & Age group(s):
Year / Team / Age Group / Head Coach
Number of years as a head coach: 20 see resume
Where, Date(s) & Age group(s):
Year / Head coach / Team name / Association / Sport
Number of years as an assistant coach:
Where, Date(s) & Age group(s):
Year / Head Coach / Team Name / Association / Sport
Number of years as an NYSCA trained and certified coach:
Other relevant experience: .
Personal References (with contact information):
I AGREE TO ATTEND THE ASSOCIATION COACH MEETING, NYSCA CERTIFICATION, COACH CLINIC, EVALUATIONS, PLAYER DRAFT, COUNTY WIDE COACH MEETING, HAVE A REPRESENTIVE PRESENT AT THE TEAM COORDINATOR MEETING AND MAKE SURE MYSELF OR AN NYSCA CERTIFIED APPROVED ASSISTANT COACH WILL ATTEND ALL GAMES AND PRACTICES.
I agree to abide by the rules and regulations set forth by the Forsyth County Parks & Recreation Department and the Sharon Springs Athletic Association and its governing By-laws. I also consent to a police background check for the purpose of establishing my suitability for coaching within this organization. THE BACKGROUND FORM MUST BE FILLED OUT IN BLUE INK AND DELIEVERED PERSONALLY TO THE AGD WITH A LEGILBE COPY OF YOUR DRIVER’S LICENSE. (The county will notarize the form if this is completed correctly).

Applicant's signature /s/ Date
You may electronically sign by typing in your name after the /s/

PLEASE NOTE CALENDAR DATES WILL BE PLACED ONTO THE WEBSITE AS SOON AS THEY ARE AVAILABLE. PLEASE READ THE SPORTS REC PAGE AND YOUR AGD’S WEB PAGE FREQUENTLY.