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SSC Coaching Application Form
Full Name (*)
Please enter your Full Name
Date of Birth (*)
Please add a valid Date of Birth (dd/mm/yy).
Address (*)
Please enter your Address
City (*)
Please enter your City
Province (*)
Please enter your Province
Postal Code (*)
Please enter your Postal Code
Telephone (*)
Please enter your Phone Number
Cell Phone
Your Email (*)
Please add a value for Your Email.
For new coaches or to update your current photo.
Upload your Photo

What Coaching position are you applying for?
Position (*)
Please select at least one of the coaching positions.

Which age level are you applying to Coach for?
(listed by year of birth of player for the upcoming season)
Age Level (*)
Please select an Age Level

What level of competition are you interested in coaching?
(for players in the U11 to U18 age groups)
Comp Level (*)
Please add a value for Comp Level.

How many daughters do you have registered with Semiahmoo Soccer Club?
Daughters (*)
Please select number of Daughters registered at SSC

Which daughter would you like to coach?
Name
Birth Year

Are you presently coaching (or planning to coach) another team at another club?
Y/N (*)
Please check Yes or No.
If Yes list team name and club:
Team Name
Club Name

Have you ever taken any courses offered by the National Coaching Certification Program (NCCP)?
Y/N (*)
Please add a value for Y/N.
If Yes check highest level course taken (NCCP)
NCCP Courses
Date of Last Course Taken
Certificate Number
Invalid Input

Would you like to receive information about additional Coach Certification Courses?
Y/N (*)
Please Check Course Info Box

Have you read the SSC Coaches Code of conduct?
Select (*)
Please add a value for Select.
Additional Comments?

Review your information and when satisfied enter the security code and click the submit application button below.
Click When Done