Coach Application - Extra Program SMAYSO
Thank you for your interest in coaching an Extra team for the upcoming Fall 2013 season. Please complete the application below. Should you have any questions, please refer to our website. If you cannot find the information, feel free to email the chair of the Extra Program at


• Current AYSO Volunteer Application Form filed at National Support & Training Center
• Compliant with training requirements for age of team being applied for per national and Area P Program Guidelines (prior to start of season)
• AYSO Safe Haven Certification
• 2 Years minimum coaching experience

Last Name *
Your answer
First Name *
Your answer
Email Address *
Your answer
Best Phone #: *
Your answer
AYSO Coach Certification Level (present) *
We STRONGLY recommend that by the start of the season, coaches for the 10U and 12U Extra divisions have their INTERMEDIATE coach certification and coaches at the 14U level have their ADVANCED coach certification. For those that don't have the required certification, check eAYSO for classes being offered nearby or contact our Regional Coach Administrator, Stephen Cooper, at or the Extra Chairs at
USSF Coach
What level of USSF Certification (E, D-State, D-National, C, B, A), Year obtained and #
Your answer
Did you use the AYSO Reciprocal agreement for licensing?
AYSO Referee Certification *
Experience Coaching/Training - AYSO *
List the Division and Type of League (i.e. Fall, All-Star, Spring, Extra)
Your answer
Number of years of AYSO Coaching/Training Experience *
List the Division and Type of League (i.e. Fall, All-Star, Spring, Extra)
Your answer
Experience Coaching/Training - Other Organization (i.e. Club)
List the Level and # of Years
Your answer
Do you intend to Coach both in the Extra Program AND the Fall Primary Program? *
Are you prepared to coach the Extra team for the entire year (June/July through May/June) *
A coach in the Extra program should be committed to both the Fall and Spring seasons.
Additional Experience you consider relevant to your application to coach an Extra team?
Your answer
Please provide 3 references to your coaching ability and their contact information. *
Please type one person per line
Your answer
Gender and Age of Division Being Requested to Coach *
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