MICHIGAN “CLASS D” CROSS-COUNTRY COACHES ASSOCIATION

​Coach Name:________________________________________________________________________________________________________

HOME ADDRESS:_________________________________________________City_________________________________ZIP_______________

Cell PHONE________________________________email_____________________________________________________________________

CHECK WHERE YOU WANT MAIL SENT:       HOME_____     OR       SCHOOL_____

CHECK ALL THAT APPLY TO YOUR COACHING POSITION:

VARSITY/JV MEN__________VARSITY/JV WOMEN__________JR. HIGH BOYS__________ JR. HIGH GIRLS_____________ 

WOULD YOU CONSIDER SERVING ON A COMMITTEE OR to BE A DIRECTOR?        YES_____ _NO______

SCHOOL NAME________________________________________________________________________________________________________

SCHOOL ADDRESS_________________________________________City_______________________________________Zip________________

ATHLETIC DIRECTOR__________________________________________AD  EMAIL___________________________________________________

ad PHONE_________________________________________________SCHOOL FAX_________________________________________________

BRING application TO championship race site  with $25.00 FOR MEMBERSHIP/Dues (CHECKS PAYABLE TO MCDXCCA) or mail TO:
MARK ZITZELSBERGER
118 West Michigan Street
Mt. Pleasant, Michigan 48858