HOOPS Basket Ball League Intake/Registration Application

Urban Hope NYC "HOOPS" BasketBall League
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Age
Gender
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone
Phone Number

Area CodePhone Number
Recent Photo ID (Selfie - Head Shot)
Marital Status
What Languages are you fluent in
FaceBook Handle
Instagram Handle
TikTok Handle
How did you hear about this basketball league?
Emergency Contact information
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please click which 1 or more NYC certifications you would like to obtain. All of the training selections will be supported by either the NYS DOL, NYC DOCA or a nationally accredited organization as HBI/PACT, the NH&LEI, NCI

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Only fill in if you go to a Church if not, fill in NA
Name of Church you attend
Name of Pastor
Pastor's Email
example@example.com
Church Phone
Church Website
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you been going to this church?
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Your Personal Testimony. How did you come to know Christ as your Personal Lord and Saviour?
Urban Hope NYC "HOOPS" BasketBall League

Your WHY
Why I want to join the Urban Hope NYC "HOOPS" BasketBall League?
Are you aware the FINALS are held in the BARCLAYS CENTRE?
What position do you enjoy to play?
What team are you on and or what team do you want to join?
Who is your favourite Player and why?
How do you feel this Basketball league will help YOU?
Are you aware this League is a designed to assist you to either pursue Higher Education or pursue gainful employment or both. We do this through a mentorship program?
Please share what your dream job of life would be. Share how you feel we can help you achieve this. Please share what you are willing to do to make your God given DREAM come TRUE.
List 3 of your strengths
List 3 of your weaknesses
“If you had your own TV show, what would it be about?”
If you could master one skill you don’t have right now, what would it be?
What stands between you and happiness?
Any Additional Documents you wish to present

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Medical background
Are you aware of any medical/physical conditions that might have a negative effect on this internship?
Do you smoke?
Do you drink Alcohol?
Do you use illicit drugs?
Have you used illicit drugs?
Doctor's name
Doctor's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Doctor's Phone Number

Area CodePhone Number
References

Someone who you feel could provide a satifactory character referance.
Name
Relationship
Email
example@example.com
Name of School (High School)
Name of School (High School)
From - To (High School Attendance Period)
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Principal's Name
Name of your Favourite Teacher
Work Experience

If you have work experience
Company Name
Position
Supervisor Name
How long did you work there?
Phone Number

Area CodePhone Number
Reason for leaving?
Description of Duties
By Submitting this Registration/Intake form you will be acknowledging that will you be part of the Basketball Leauge and Urban Hope Mentorship Program. To play basketball in this league you will be part of the mentorship league.
Should be Empty:

Urban Hope NYC "HOOPS" BasketBall League

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Urban Hope NYC "HOOPS" BasketBall League

References

Name of School (High School)

Work Experience