TOPSoccer

CERTIFICATE OF COMPLETION/NON-COMPLETION

Attitude:	___	Poor	___	Fair	___	Good	___	Excellent
Conduct:	___	Poor	___	Fair	___	Good	___	Excellent
Participation:	___	Poor	___	Fair	___	Good	___	Excellent
Appearance:	___	Poor	___	Fair	___	Good	___	Excellent
Arrive on time:	___ Yes	___	No

I certify that _________________________ has completed ________ sessions of community service in the District III TOPSoccer/Disciplinary Alternative Program. Compliance with the Code of Conduct and/or duties assigned to him/her were performed in a unsatisfactory manner.

Attitude:	___	Poor	___	Fair	___	Good	___	Excellent
Conduct:	___	Poor	___	Fair	___	Good	___	Excellent
Participation:	___	Poor	___	Fair	___	Good	___	Excellent
Appearance:	___	Poor	___	Fair	___	Good	___	Excellent
Arrive on time:	___	Yes	___	No

Failed to Appear:

Date:______________

______________________________
District III TOPSoccer Director

______________
Date

Mail this form within 48 hours to:
District III Disciplinary Committee
501 30th St. NE D-2
Auburn, Washington 98002

Note: The player/coach will get a copy of this just for their reference. The TOPSoccer Administrator will have copies for the coaches/administrators to fill out and return to District III.