NEW 2023 - 2024 AYSO REGION 122         SANTA BARBARA                                        ALL-STAR COACH APPLICATION
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Email *
CURRENT 2023-2024 SEASON INFORMATION:
Coach Email *
Coach Full Name: *
Coach Home Address: *
Coach Cell Phone Number: *
What gender and division would you like to be considered for as an all-star coach?
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How many years have you coached soccer?
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Where have you coached?
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What is your highest level of Coaching Certification for AYSO you have?
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Required
Do you have any other coaching certifications? (i.e. USSF E/F License, etc)
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If yes or other, please explain.
Have you ever had a misdemeanor or felony charge?
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If yes, please explain:
Have you been Live Scanned and Fingerprinted?: *
Date of your Live Scan and Fingerprint:
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Have you been Sterling Background Checked?: *
Date of your Sterling Background Check:
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Date of your last Safe Haven Certification:
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Date of your last CDC / Concussion Certification:
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Date of your last SafeSport: *
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Date of your last Sudden Cardiac Arrest: *
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Are you coaching your son or daughters 2023 AYSO team?: *
Required
If you are coaching your son or daughters team, What is their name? *
Are you a Head Coach or are you an Assistant Coach for an AYSO Team this season 2023?: *
If you are , what Gender and Division are you coaching?: *
What Team# number are you Coaching?:
What is your Son or Daughters team Jersey Color you are coaching? *
What is your Son or Daughters Jersey Number #:  *
Do you have previous All-Star experience?
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If you do have previous All-Star Experience, please explain:
What is the highest level that you are Certified as a Referee? *
Required
Are you willing to help be a Center Referee or an Assistant Referee for your Team in Tournaments if needed ?:  *
Required
The post-season usually lasts from November 2023 through June 2024. The Area / Sectional / Tri-Sectional tournaments take place on multiple weekends during the months of January 2024, February 2024 & March 2024. Do you have any commitments that may conflict with coaching an all-star team?
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If you answered yes or maybe, please explain:
Could your occupation cause you to cancel practices or not attend tournaments?
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If you answered yes or maybe, please explain:
Do you understand if chosen to coach an All-Star team, you and your team are required to help run the Santa Barbara Splash Tournament the first week of June 2024?
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If you answered No or maybe, please explain:
Briefly state why you would like to be an All-Star coach. What would be the goals that you would like to accomplish during the post-season? What criteria would you use for selecting all-star players?
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Please provide any other information which you feel would be helpful or relevant:
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Please list the name, address and telephone number of two persons who know you sufficiently well to comment on your past coaching or your potential as a coach:
Reference #1 - Full Name
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Reference #1 - Phone Number
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Reference #1 - Email
 *
Reference #2 - Full Name
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Reference #2 - Phone Number
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Reference #2 - Email
 *
By entering your initials & date in the boxes below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. You are also acknowledging you have read and agreed with the Player and Parent Commitment Letter (link below).
https://docs.google.com/document/d/1Uw_vqgNIKciYFffmbRhace97DQbe-86U7dj48a_-rpk/edit?usp=sharing
Initials:
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Today's Date:
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A copy of your responses will be emailed to the address you provided.
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