Team Official Application

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Work Phone

Mobile Phone

Email*

Coach License

Position*

Do you have a child?*

What is your child's name?*

Have you coached before?*

How many years of coaching experience do you have?*

Have you coached before for CUSC?*

What is the name of the CUSC team that you coached?*

What gender did you coach?*

What age level did you coach?*

Chesapeake United Soccer Club