Missouri State High School Soccer Coaches Association
2016-2017 Membership Application
School:

School address:

School phone:


2016-2017 MSHSSCA dues:
Head coach Boys OR Girls:  $35

Name:

Email:

Cell/home phone:

I Coach:

Head coach Boys AND Girls:  $50

Name:

Email:

Cell/home phone:

Assistant coach boys: $15

Name:

Email:

Cell/home phone:

Assistant coach girls:  $15

Name:

Email:

Cell/home phone:



Additional assistants:  $10 each

Name:

Email:

Cell/home phone:

Name:

Email:

Cell/home phone:






Before submitting your application, please be sure that ALL fields are completed.  We cannot process your membership if any fields are left blank.  Thank you!

Interested in joining the NSCAA as well?  MSHSSCA members can join the NSCAA and receive a $25 discount off their membership!  When your MSHSSCA membership application and dues are received, you can use MOHSS at nscaa.com to receive the discount.


Would you like to make a donation to the Coaches Support Fund?  Amount: $    
Donations are used to assist our fellow coaches in their time of need.  Please visit http://www.mosoccercoach.com/coachessupport.html


Total amount due:  $


















We accept PayPal!  After visiting PayPal or Dashboard, please be sure to return to this page and submit your membership application!
Or you may send a check made payable to MSHSSCA to:

Chris Miller
President, MSHSCCA
19951 S. Hartsburg Hills Rd.
Hartsburg, MO 65039

Note that membership applications will be processed once payment has been received.