COACHING COURSE APPLICATION

SPONSORING ORGANIZATION ________________________________

Course Type__________ (Specify Youth Module I, Youth Module II, Youth Module III or E, D)

REQUESTED DATE(S) FOR COURSE ___________________ALT.DATE _________

COURSE COORDINATOR: (This person is the contact person responsible for organizing and setting up the course and site preparations)

Name: ________________________________ Phone (H) ________________

Address: ______________________________            (W) _________________

               _______________________________           (C) __________________

Coordinators Email Address: _______________________________________________

COURSE LOCATION: (This site must have:(a) Good to excellent field with goals, nets, corner flags, & markings (b) classroom or meeting room for lectures with blackboard or white board (c) projection screen or area to project image.)

LOCATION of SITE: ____________________________________________

ADDRESS of SITE :  _____________________________________________

(Please attach good site directions to this application)

*A completed Application must be received by MSYSA before a course can be approved and scheduled.

MAIL APPLICATION TO: MSYSA/Course Coordinator

PO BOX 667

Millersville, MD 21108

FOR MORE INFORMATION: (410) 987-7898

(Linda Craig, MSYSA Office) coursecoord@msysa.org

For MSYSA Office Use Only: