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VOLUNTEER COACH APPLICATION

Football                                          Cheerleading

Grade        Head Coach         Assistant Coach 

Date of Application //         Name

Other Names (maiden, alias, etc) Sex M F

Social Security Number      Drivers License Number

Home Address  City State Zip 

Home Phone #     Work Phone

Employment

Present Employer  Name of Supervisor

Address City State Zip 

Date of  Employment

 

References (List 3 not related)

Name Address Phone
Name Address Phone
Name Address Phone

Have you ever been arrested, charged or convicted of a crime ? If yes explain

Have you ever been involved in an incident involving child abuse or neglect? If yes explain

Have you ever had or do you have a problem with drugs and/ or alcohol? If yes explain

Reason for volunteering?

List the sports you have coached

List any formal training you have received in coaching

**** IMPORTANT NOTICE ****

All coaches must be NYSCA Certified and agree to a state back ground check. The fees for these activities will be the responsibility of the coach. The LWYFL will notify all coaches when and how they need to submit their NYSCA and back ground check data.

 

Check if you agree to the terms above.                     Date:  

NYSCA Number from last year if available    

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