Missouri State High School Soccer Coaches Association
2013-2014 Membership Application


School:

School address:

School phone:


2013-2014 MSHSSCA dues:

Head coach boys:  $35

Name:

Email:

Cell/home phone:

Head coach girls:  $35

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:

Name:

Email:

Cell/home phone:


Additional coaches (free of charge): 






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 $15 discount off their membership!  When your MSHSSCA membership application and dues are received, you will be sent a confirmation email that includes a discount code to use when you register at nscaa.com.


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, 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
4008 Compton Rd.
Columbia, MO 65203

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

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