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Coach/Trainer Application Form

If you are interested in becoming a Dundee United Coach or Trainer, click on the Coach/Trainer Application Form link below to generate an Email and fill out the relavent sections listed below. Submissions will be directed to the Vice President and the Director of Coaching.

E-mail: Coach/Trainer Application

I. PARTICIPANT INFORMATION:

  • Your Name: First, Middle Initial, Last
  • Your Home Address
  • Your Home Phone Number
  • Your E-mail Address
  • Social Security Number
  • Date of Birth: MMDDYYYY
  • Gender: Male or Female
  • Driver's License: State & Number
  • Driver's License Exp. Date:

II. BACKGROUND/EXPERIENCE

  • Background working with Youth
  • Background in Soccer
  • Experience in Youth Soccer
  • Your E-mail Address
  • Social Security Number
  • Date of Birth: MMDDYYYY
  • Gender: Male or Female
  • Driver's License: State & Number
  • Driver's License Exp. Date:

III. POSITION OF INTEREST

Please select your primary area of interest:

  • Coach
  • Trainer
  • Assistant Coach
  • Team Manager
  • Age Group Coordinator
  • Referee

IV. KIDS SAFE PROGRAM

Dundee United is an active participant in the Kids Safe Program. We therefore require all positions to answer the following questions:

  • Have you lived at your present address for the past 5 years?
  • If "No" please enter previous address of residence
  • Have you ever been convicted of a violent crime?<
  • Have you ever been convicted of a crime against a person?
  • If you answered yes to any of these questions, please explain:

V. DISCLOSURE AGREEMENT

Please read the following statement and check the box below to indicate your agreement:

I, the applicant, understand and agree to the following:

It is the intent of the Illinois Youth Soccer Association (IYSA) and Dundee United to deny certification and participation in IYSA and/or Dundee United programs to any person who has been convicted of a crime of violence or a crime against a person.

Falsification of information on this disclosure statement may be grounds to deny certification and participation.

The disclosure statement shall be deemed to have continuing validity unless I have been convicted within the preceding year of a violent crime or a crime against a person. In such case I shall resubmit an updated Volunteer Disclosure Statement.

In volunteering for a position with Dundee United, I hereby authorize the release of records pertaining to any criminal and domestic abuse history. This authorization is given in connection with a background investigation which may be conducted relative to my volunteering. Any information obtained by a background check will be considered in determining my suitability for a position within Dundee United. In the even that as a result of a background check my services are rejected, the sources of confidential information cannot be revealed to me. Further, I agree to indemnify and hold harmless the Illinois Youth Soccer Association, its agents, Dundee United, its agents and the person to whom this request is presented as well as his/her agents from and against all claims, damages, losses and expenses, including attorney's fees arising out of or by reason of compliance with this request.

*I agree to the above statement.