To submit this form, complete the application sections and attach all required documents. Return the completed application and attachments to the Bureau of Educator Standards and Certification at P.O. Box 150471, Hartford, CT 06115-0471. You can also contact them at www.ct.gov/sde for further instructions on submission. My advice is to ensure all information is accurate and complete before submission to avoid any delays.

Ensure your first aid, CPR, and concussion training courses are completed within the past three years. Renewal applicants must complete 15 clock hours of relevant seminars or courses.

The purpose of this form is to allow individuals to apply for or renew a five-year renewable coaching permit in Connecticut. This form collects personal information, verifies completion of required training courses, and ensures applicants meet the necessary criteria for obtaining the permit. Proper submission and processing of this form enable qualified individuals to receive their coaching permit, allowing them to legally coach in the state of Connecticut.

• 1. Part I: Personal Information: Collects personal details, including name, social security number, address, contact information, and race/ethnicity.
• 2. Part II: Completion of Required First Aid Course: Requires information and documentation of a completed first aid course.
• 3. Part III: Completion of Required CPR Course: Requires information and documentation of a completed CPR course.
• 4. Part IV: High School Information: Requires a copy of the applicant's high school diploma or transcript.
• 5. Part V: Concussion and Head Injury Training Requirement: Requires documentation of completed concussion and head injury training.
• 6. Part VI: Completion of Required Coaching Course: For individuals without a valid Connecticut educator certificate, requires documentation of completed coaching course.
• 7. Part VII: Renewal of Five-Year Renewable Coaching Permit: Verification of completion of 15 clock hours of relevant training for permit renewal.
• 8. Part VIII: Applicant Attestation: Applicant certifies that all provided information is true and accurate and signs the form.

Failure to submit this form may result in your inability to obtain or renew your coaching permit.

• Inability to Coach Legally: You will not be authorized to coach in Connecticut without a valid permit.
• Potential Penalties: Coaching without a valid permit may subject you to penalties or legal actions.
• Missed Opportunities: You may miss out on coaching opportunities if your permit is not renewed or obtained on time.

• 1. New Applicants: For individuals applying for a new coaching permit.
• 2. Renewal Applicants: For individuals renewing their existing coaching permit.
• 3. Training Verification: To verify completion of required first aid, CPR, and concussion training courses.
• 4. Certification Verification: For individuals without a valid Connecticut educator certificate to verify coaching course completion.
• 5. Updating Personal Information: To update your personal information and ensure it is accurate on your coaching permit.