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SUSC Coach / Manager Application
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* Indicates required question
Email
*
Your email
Last Name
*
Your answer
First Name
*
Your answer
Phone Number
*
Your answer
Mailing Address
*
Your answer
Are you submitting this application only for a team manager role? (If Yes, then you can leave all coach certification questions blank)
*
Yes
No
Grassroots Coaching Certification(s) that you currently hold
Active Start
Fundamentals
Learn to Train
Soccer For Life
None
Coaching Certification Completion Date(s) (Please list the certification as well as the corresponding date of completion)
Your answer
List any Grassroots Certification Course that you are currently involved in and when you began the course (i.e., Learn To Train, began January 2023)
Your answer
Advanced Licensing Stream that you currently hold
B License Pre-Test
Provincial B
National C
National B
National A
CSA Children's License
CSA Youth License
Advanced License Completion Date(s) (Please list the certification as well as the corresponding date of completion)
Your answer
Other Sports/Soccer Certifications that you hold and Date(s) of Completion
Your answer
Team Coached and/or Managed - Current Season (ie SUSC U11 Girls Royals)
Your answer
Team You are Applying to Coach/Manage in Upcoming Season (ie SUSC U12 Girls Royals)
Your answer
Do you have a valid Respect in Sport Activity Leader Certification on file with SUSC?
*
Yes
No
Respect in Sport Activity Leader Certification Number (if known)
Your answer
Do you have a valid Criminal Record Check on file with SUSC?
*
Yes
No
Criminal Record Check effective date (if known)
MM
/
DD
/
YYYY
I understand anyone on the field with players at any time must have their Respect in Sport Activity Leaders certification and a criminal record check in place before they can be on the field.
Contact riskmanagement@surreyunitedsoccer.com if you need information or have not provided your certification number to the club.
*
Yes, I understand this must be in place before I can be on the field with SUSC players
No
I Agree with SUSC's Code of Conduct and Ethics and agree to abide by all SUSC Policies as updated from time to time.
*
Yes
I understand I will be restricted to coaching/managing two (2) teams in any given season.
*
Yes
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