Name ___________________________________________________
Address__________________________________________________
City___________________________ State_________ Zip________
Email _____________________________ Email 2 _____________________________
1. School Name___________________________ Conference ______________________
Circle: High School / College Circle: Boys / Girls
AD Name_________________________ AD Phone _________________________
2. Club Name ____________________________ Age _________ Circle: Boys / Girls
Circle Affiliation: WYSA WASA YMCA Other ___________________________
3. Circle Your Level of Coaching Certification
USSF: State G E D Youth Level I II III National C B A
NSCAA: State Regional National Advanced National Goal Keeper
Send Check & Application to: WSA
WSCA Membership Attn. Jenny
10708 West Hayes Ave.
West Allis, WI 53227
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The WSCA depends upon volunteers to run all its programs. Please consider helping with some of the following activities and then circle all items that you are interested in.
YOUTH HIGH SCHOOL COLLEGE ADULT