Scarsdale Youth Soccer Club

CoachApplication

*Date *Name *Address (Street, City, State, Zip)
If you have lived at this address for less than five years, please list prior address(es)
*Home Phone *Work Phone *Cell Phone *Email Addresses
*Age Groups/Gender Requested (check all applicable)
U09
U10
U11
U12
U13
U14
HS
Girls
Boys
Team Name (if known) *1. Work History (last 5 years). Include Company Name, Position and Dates of Employment
*2. Why do you want to coach a Travel Team (be specific)
*3. Have you ever "played" soccer?
Yes
No
*3a. Please indicate where you played soccer - include the level (Youth, HS, College, etc.) Dates Played, School and Type of program
*4. What other sports have you played? (Include sport, level, type of program and dates).
*5. Have you ever coached Soccer?
Yes
No
*5a. Please indicate the Club(s) in which you coached, the elvel, number of years, league name and location
*6. What other sports have you coached? Please indicate the Sport, Sponsoring agency, Age, Level and and Years Coached
*7. Have you had any formal training as a coach?
Yes
No
*7a. Please describe formal coach training (e.g., PE degree, coaching licenses, courses, clinics, etc.)
Please prepare copies of certificates or licenses for inclusion in a final review.*8. Describe any information training that would help you coach (e.g., working with youths...)
*9a. Rate your knowledge of SKILLS and STRATEGIES OF SOCCER
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it.
*9b. Rate your knowledge of DEVELOPING SPORTSMANSHIP
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*9c. Rate your knowledge of RULES OF THE SPORT OF SOCCER
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*9d. Rate your knowledge of COMMUNICATION SKILLS
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*9e. Rate your knowledge of WARM-UP AND PHYSICAL CONDITIONING
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*9f. Rate your knowledge of ORGANIZING PRACTICES
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*9g. Rate your knowledge of INJURY PREVENTION AND TREATMENT
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*9h. Rate your knowledge of PRINCIPALS FOR TEACHING SOCCER SKILLS
1-You know very little about it
2-You have reasonably good knowledge about it
3-You know a great deal about it
*10. Have you ever received treatment for alcohol or drug abuse?
Yes
No
*11. Have you ever had charges brought against you for child molestation, abuse or neglect?
Yes
No
*Do you have any first aid training?
Yes
No
*13. Please list the names, addresses, and phone numbers of TWO persons who know you sufficiently well to comment on your past coaching or your potential as a coach
*14. Have you ever been arrested or convicted of an offense against the law other than a minor traffic violation?
Yes
No
14a. If you answered YES to q14, please explain fully.
Other comments that you may consider appropriate
*An online background check is required once every two years.
Yes, I understand that I am required to enter my social security number online as part of the required background check
ENTERING my SS# online is a problem for me.

If accepted for a coaching position, I hereby acknowledge that if appointed I will serve at the pleasure of, and agree to abide by the rules and regulations of, the Scarsdale Youth Soccer Club, Inc.

I understand that the information which I have furnished herein is subject to verification, which may include a criminal background check and reference interview. By checking "YES" below, I give my consent to authorize reference interviews and a background check.

*Please indicate your acceptance of the terms and conditions of becoming a coach as defined above.
YES, I agree to the terms and conditions as described above.