Coaching Application - Pelham Raiders Minor Lacrosse Association

Field Staff Application 2025

Fields marked with an * are required.

Name

First Name

Last Name

First and Last Name

Address

Street Address

City

Country

Phone

If yes, please list which teams, divisions, and organizations (lacrosse or other).

If not applicable, please enter 'n/a.'

If yes, please list which teams/levels.

If not applicable, please enter 'n/a.'

Please describe why you wish to coach within the Pelham Raiders organization.

Please add any other pertinent notes/comments.

NCCP#

Please enter you NCCP# (National Coaching Certification Program Number) here (if applicable).

Discount

Subtotal

Tax

Total USD