Site:

If school, affiliated with what school district?:

Address:

City:

State:

ZIP:

Phone:

Fax:

The Site Liaison assures the smooth implementation of the program by securing appropriate practice space, assisting with registration, and serving as a link between coaches and the school (see Liaison Role Description for additional details).

Liaison Name:

Title/Role:

Liaison Phone:

Liaison Email:

Site details

Briefly describe the available running area:

Briefly describe the available meeting space:

Briefly describe the available indoor space:

Please note any and all options for outreach at your school including newsletters, PTA meetings, flyer boards, etc.:

What grade levels does your school/organization serve?

Would communication in languages other than English be needed? If so, what languages?

If you are applying on behalf of a school, please estimate the total number of 3rd, 4th, and 5th grade girls at your school:

Briefly describe your recruiting and selection criteria .

Please describe area and how it will be accessed:

Candidate Information

Candidate 1 Name:

Candidate 1 Role:

Candidate 1 Phone:

Candidate 1 Email:

Candidate 2 Name:

Candidate 2 Role:

Candidate 2 Phone:

Candidate 2 Email:

Candidate 3 Name:

Candidate 3 Role:

Candidate 3 Phone:

Candidate 3 Email:

Substitute Candidate 1 Name:

Substitute Candidate 1 Role:

Substitute Candidate 1 Phone:

Substitute Candidate 1 Email:

Substitute Candidate 2 Name:

Substitute Candidate 2 Role:

Substitute Candidate 2 Phone:

Substitute Candidate 2 Email:

Would your site like to be considered for more than one team (up to 16 girls)?

--None-- Yes No ;

If yes, how many teams of 16 girls can your site accommodate (considering practice facilities)?

Team 1 Days:

Team 1 Times:

Team 2 Days:

Team 2 Times:

Team 3 Days:

Team 3 Times:

Please include any information you'd like to share with us about ability to pay among your participants:

School Principal

Principal Name:

Principal Phone:

Principal Email: