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Applicant Nm: Home Ph:
Street Address: Home City:
Home State: Home Zip:
Home Email:    
School Name: School Ph:
School Address: School City:
School State: School Zip:
School Email:    

Division...          

District...                

  High School Varsity Fastpitch Coaching record (not including JV or summer team)    Wins:      Losses:

  Number of years you have coached High School Varsity Fastpitch Softball Teams...      Years of Service:

  Associate: $15 (all coaches - no voting Privileges)
  Active: (varsity Head Coaches)   C-$35,    E-$30,    NE-$35,    NW-$35,    SE-$30,    SW-$40

  Membership Level...         Amount Submitted:


  Make NorthWest District checks out to NWDFSCA.
  Make all other checks out to your District Treasurer - listed below.
  Submit this form with your check to your District Treasurer.

  • CENTRAL
  • Kevin Moody
  • 6580 Sherry Ln
  • Hilliard, OH 43026
  •  
  • NORTHWEST
  • Garry Rodenberger
  • 2225 Ginter Road
  • Defiance, OH 43512

  • EAST
  • Don Bethel
  • 688 Kerr Ave.
  • Cadiz, OH 43907
  •  
  • SOUTHEAST
  • Adam Bailey
  • 2201 Shela Blvd.
  • Portsmouth, OH 45662
  • NORTHEAST
  • Shelley Monas
  • Box 54
  • Perry, OH 44081
  •  
  • SOUTHWEST
  • Rick Armstrong
  • 2361 Sugar Maple
  • Kettering,OH 45440