TO COACH AT A NFMSS SANCTIONED EVENT – YOU MUST TAKE THE COURSES AND PAY THE $35 FEE

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ARE YOU APPLYING FOR THE 2026 CALENDAR SEASON:

• Yes
• No

SECTION 1 — PERSONAL INFORMATION

FULL LEGAL NAME:

Preferred Name (if different):

DATE OF BIRTH:

GENDER

• Male
• Female
• Other

Social Security Number (Last 4 Digits Only):

SECTION 2 — CONTACT INFORMATION

Home Address

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone Number

Email Address *

SECTION 3 — SPORTS & COACHING INFORMATION

SCHOOL NAME:

SCHOOL ADDRESS:

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

ATHLETICS DIRECTORS NAME: *

First

Last

ATHLETIC DIRECTORS EMAIL: *

COACHING POSITION

COACHING ROLE

• Head Coach
• Assistant Coach
• Volunteer Coach
• Strength & Conditioning Coach
• Skills Trainer
• Stats Keeper

SPORTS YOU WISH TO COACH

• FOOTBALL
• BASKETBALL
• BASEBALL
• SOFTBALL
• SOCCER
• VOLLEYBALL
• TRACK
• FLAG FOOTBALL
• TENNIS
• CHEERLEADING
• SWIMMING

LEVEL OF COACHING (Click all that apply):

• Youth
• Middle School
• Junior Varsity
• Varsity
• College
• Other

COACHING EXPERIENCE:

• New Official
• 1-2 Years
• 3-5 Years
• 6-10 Years
• 10+ Years

PREVIOUS SCHOOLS / ORGANIZATIONS COACHED (Please list all or type N/A))

BEEN CHECK ID:

COACHING CERTIFICATIONS (List all the Apply)

OTHER CERTIFICATIONS HELD:

• NFHS Certified
• State Association Certified
• CPR Certified
• First Aid Certified
• Concussion Training Completed
• SafeSport Certified
• Other

SECTION 5 - EMERGENCY CONTACT

Emergency Contact Name:

RELATIONSHIP:

PHONE NUMBER:

SECTION 6 - BACKGROUND INFORMATION

Have you ever been suspended or removed from officiating duties? (If so please explain):

Have you ever been convicted of a felony? (If so Please Explain):

HAVE YOU EVER BEEN CONVICTED FOR CRIMES AGAINST CHILDREN?:

• Yes
• No

PLEASE UPLOAD YOUR GOVERNMENT ID:

Click or drag a file to this area to upload.

SECTION 7 - DOCUMENTS REQUIRED

WHICH OF THESE DOCUMENTS CAN BE ATTACHED (All may be required):

• Government Issued ID
• Certification Documents
• Background Check Authorization
• CPR / First Aid Certifications
• SafeSport Certificate
• W-9 Form
• Passport Style Photo

SECTION 8 - AGREEMENTS & ACKNOWLEDGEMENTS

PLEASE CHECK EACH ITEM:

• I certify that the information provided is true and accurate.
• I agree to comply with all NFMSS rules, regulations, and codes of conduct.
• I understand that officiating assignments are subject to availability and approval.
• I consent to background verification procedures if required.
• I agree to maintain professional conduct at all events.

Signature

Clear Signature

Date / Time

Date

Time

Stripe Credit Card *

Name *

First

Last

Submit

Mandatory Courses Below

⚠️ You must be logged in as a registered coach to take this certification course.

⚠️ You must be logged in as a registered coach to take this certification course.

⚠️ You must be logged in as a registered coach to take this certification course.