Your name:


E-mail address:

Gender:	Gender Male Female      Date of Birth (month/day/year):
SSN # :
Position Applied For:	Select One Field player Coach Goalkeeper Coach Player Development Officer Athletic Trainer Administrative Staff
Contact Information
Address
Street:
City:	State: Zip Code:
Country:
Phone:	Cell:
Education and Experience
Occupation:	Education Level:
Coaching Licenses and Experience:
Camp Experience:
Equipment
Height:		Weight:
Jersey:	Size XL L M S	T-Shirt:	Size XL L M S
Shorts:	Size XL L M S	Gloves:	Size 12 11 10 9 8 7 6

Summer Availability

Please select the camps you are available to work for and if you can provide your own transportation.
Under NCAA regulations Connecticut Soccer School cannot provide transportation for NCAA student
athletes. Staff are required to arrive Saturday 6pm the day before camp to help with camp set-up.
All new applicants must also forward two written references to:

Connecticut Soccer School

Human Resources
PO Box 3
South Glastonbury CT 06073 USA
 

DATE	STATE	LOCATION	AVAILABILITY	CAN YOU PROVIDE TRANSPORTATION
Jun 28-July 2	RI	Bryant College, Smithfield	Select One Available Not Available	Yes No
July 5-9	CT	The Westminster School, Simsbury (Girls Week)	Select One Available Not Available	Yes No
July 12-16	Canada	Brock University, St. Catharines	Select One Available Not Available	Yes No
July 19-23	CT	The Westminster School, Simsbury	Select One Available Not available	Yes No
July 26-30	CT	The Westminster School, Simsbury	Select One Available Not Available	Yes No
Aug. 2-6	CT	The Forman School, Litchfield	Select One Available Not Available	Yes No
Aug. 9-13	MA	Cushing Academy, Ashburnham, Massachusetts	Select One Available Not Available	Yes No

References:


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