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* 1. In which region are you wanting to coach?

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* 2. Name

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* 3. Club you are currently registered to?

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* 4. Which team you are wanting to Coach? ( Please note in some age groups, there is multiple teams from each region)

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* 5. Mobile Phone

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* 6. Email

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* 7. What is your current coaching level?

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* 8. Coaching Experience

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* 9. Coaching Philosophy

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