Membership Application

       Indiana Coaches of Girls Sports Association

This application form can be found on the website: icgsa.org

NAME: ___________________________________________________GENDER:_____________

HOME ADDRESS: _______________________________________________________________

CITY: ____________________________________________STATE: _______ZIP: ____________

SCHOOL: _______________________________________________________________________

HOME PH: (_____)_______________________SCHOOL PH: (_____)______________________

PREFERRED EMAIL ADDRESS: ___________________________________________________

OTHER EMAIL ADDRESS:_______________________________________________________

 

SPORTS COACHING:

BB

CC

GF

GY

SC

SB

SW

TE

TR

VB

Varsity

______

______

______

_____

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______

______

______

_____

Junior Varsity

______

______

______

_____

______

______

______

______

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_____

Freshmen

______

______

______

_____

______

______

______

______

______

_____

Middle School

______

______

______

_____

______

______

______

______

______

_____

 

( BB = Basketball: CC = Cross Country: GF = Golf: GY = Gymnastics: SC = Soccer:  SB = Softball:  SW = Swimming: TE = Tennis: TR = Track: VB = Volleyball)

 

Number of years you have coached girls including this year: ________________________________________________

                                                                                                                       

Committees in which you have an interest in serving: _____________________________________________________

        Note: W = Willing to Serve                  C = Committee          O= Currently on               P = Pollster (team rater)

 

       Example: OTRC means on Track Committee; WVBP means willing to be a volleyball rater

 

COMMENTS: ____________________________________________________________________________________

 

CHECK ONE OF THE FOLLOWING IN EACH AREA:

________New     ______Renewal                                

 

________$35 for 1-year membership     ________$90 for 3-year membership

 

Note that there is a one dollar charge made for an online membership application.

 

Make check payable to ICGSA and Send with Membership Form to:

Darlene Matthew, Indiana Coaches of Girls Sports Association

13217 N. 1000 E

Syracuse, IN 46567     

                       

Questions can be directed to:

Phone:  574-457-6042

dmathew@ligtel.com