CANXL

TRAINER INQUIRY - APPLY NOW

* indicates required

First Name *

Last Name *

Email *

Phone

( ) -

Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Birthday

Month / Day

WHEN ARE YOU INTERESTED IN GETTING CERTIFIED? *

WHICH BEST DESCRIBES YOU? *

TELL US WHY YOU WOULD LIKE TO BE CANXL CERTIFIED *

HOW WOULD BEING CERTIFIED HELP FULFILL YOUR GOALS? *

HOW WOULD IT HELP YOU BETTER SERVE YOUR CLIENTS? *

YOUR SOCCER BACKGROUND *

Include your top (3) highlights of your soccer playing or coaching experience (ex: Player CV, Work history, etc)