I Would Like to Apply for the Rebate Program for the Gaia-UPA Coaching Corps Level 1 Clinic

USA Ultimate Coaching Development Program Workshop Presented by Five Ultimate Women’s Rebate Application

The Coaching Development Program (CDP) Workshop Rebate Program will subsidize up to $80 of the registration fee for participation in either USA Ultimate CDP Level I or Level II Workshops presented by Five Ultimate. The following participants are eligible to apply: women who coach a team in any division (open, women’s or mixed) men who coach women's or mixed teams maximum of two coaches per team

Program Rules

Please use this checklist to make sure you meet all program requirements prior to sending in your application.

In order to be eligible, applicants must:  have a current, cleared NCSI background check, http://www.usaultimate.org/resources/athlete_protection.aspx  have a current Coach, Coach/Player or Lifetime membership, http://www.usaultimate.org/membership/default.aspx  pay the initial workshop registration fee via your USA Ultimate member account  become a USA Ultimate certified coach (have attended clinic and passed test already)  coach a team in a USA Ultimate Championship or sanctioned event and be listed on team and event roster  make sure all team members on event roster have full USA Ultimate memberships  not be a player on the team he/she is coaching  meet all program rules within the last 12 months

Application All questions are required. Name [First]: [Last]: Sex:

Mailing Address: Apt/Ste: City: State: Zip:

Email: Phone: USA Ultimate ID#:

USA Ultimate Coaching Corps Workshop Information: Date: //

Location (City and State):

Information about the team you are coaching: Team Name: Team’s Division: Section/Region:

USA ULTIMATE 5825 Delmonico Drive, Suite 350, Colorado Springs, CO 80919 Web: www.usaultimate.org Email: [email protected] Tel: 719-219-8322x133 USA Ultimate Coaching Development Program Workshop Presented by Five Ultimate Women’s Rebate Application

USA Ultimate Event Name:

Event Date:

Completed applications may be returned to [email protected].

USA ULTIMATE 5825 Delmonico Drive, Suite 350, Colorado Springs, CO 80919 Web: www.usaultimate.org Email: [email protected] Tel: 719-219-8322x133