KMSC Coach Registration

This Registration form is for Information Gathering purposes only. If you are interested in coaching a KMSC team for the Fall 2006/Spring 2007 season, please complete this form and hit SUBMIT. If selected to coach a team, you will be asked to complete an official registration form and provide the necessary information.

Rec coaches will also be asked to participate in a 3 hour training session prior to the fall season.

ALL INFORMATION WILL BE KEPT CONFIDENTIAL AND WILL BE FOR CLUB INTERNAL USE ONLY

Name
Address
City & Zip	,WI
Phone
E-Mail*
Child's Name
* E-mail address will be used for efficient communications with coaches and managers.

Miscellaneous Information:
What age group are you interested in coaching for the 2007-08 season?	- U6 (PeeWee) U7 U8 U9 U10 U11 U12 U13 U14 U15 U16 U17
What type of coaching are you interested in?	- Head Coach Assistant Coach Either One
Recreational league or select league?	- Rec Coach Select Coach Either
Current coaching level license	<None> G Youth 1 Youth 2 Youth 3 E D C B A
Describe any coaching and/or playing experience. (List club name, ages, state & # of years)
Describe your coaching aspirations (including how long you would like to coach)
Have you had any applicable experience working with young people besides in soccer? (Briefly describe where and when):