MEMBERSHIP FORM FOR
SCHOOL MEMBERSHIP

School Membership:
1-10 Coaches $50 per year plus $8 per coach
11-20 Coaches $75 per year plus $8 per coach
More than 20 Coaches $100 per year plus $8 per coach

ROSTER OF ALL COACHES ON STAFF Complete application and mail with
check payable to ICA to:

John K. Elder
Illinois Coaches Association
Box 240
Alexis, IL 61412

or

Sara Kinney
Chillicothe Jr. High
914 W Truitt
Chillicothe, IL 61523


City St Zip

Coach Sports Home Address

1.

2.

3.

4.

5

6.

7.

8.

9.

10.

11.

12.