Slidell Youth Football Association - (Slidell, LA)

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SYFA Football/Cheer Coaching Application

Coaches Information

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

Home Phone:

* Cell Phone:

* Email Address:

Occupation::

What Division Would you prefer to coach in?

PeeWee (5 & 6):

Division I (7 & 8):

Division II (9 & 10):

Division III (11 & 12):

Division IV (13 & 14):

Would you prefer to be?:

* If you were not able to coach in that division, would you be open to another:

* Did you coach at SYFA last year?:

* If yes, which team and which division? Are you a returning Head or Assistant Coach?:

If No, Have you coaches at SFYA in the past? If yes, when? and how many years?:

* Do you have any other coaching experience?:

* If so, please list where and how long:

* Are you NYSCA certified?:

* If yes, is your membership current:

* NYSCA Member Number:

* Date of Issue:

* Date of Expiration:

* Are you currently under indictment:

* Have you ever been convicted of a felony:

* Have you used, or are you using any illegal drug(s):

If you answered yes to any of the three previous questions, please explain:

By filling out this application, I understand that it does not guarantee that I will be a head coach or an assistant coach. Furthermore, I understand that the Board of Directors can use my drivers license number and social security number to perform an NCIC background check.If I am selected to coach at SYFA,I agree to conduct myself in a manner specified in the rules and by-laws of the organization. I also certify that all the information included in this application is true and correct as of this current date.

* Date of Birth:

* State Issued:

* Last four digits of your Social Security Number:

I/we agree that all the information that has been provided on this application is true and correct.

For SYFA Use ONLY ! ! ! ! ! ! ! ! ! ! ! !! ! ! ! ! ! !!! ! ! ! ! ! ! ! !! ! !! ! ! !!! ! !! !! ! ! ! ! ! !! ! ! !! ! !!
Approved: _____ Division:________________Team_____Head_______Assistant

Refused:________

Signature of SYFA Offrcer:____________________________Date_____________

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