YOUTH SPORTS HEAD COACH APPLICATION

YOUTH SPORTS HEAD COACH APPLICATION
NAME*

First NameLast Name
HOME PHONE*
Please enter a valid phone number.
WORK PHONE
Please enter a valid phone number.
CELL PHONE
Please enter a valid phone number.
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
ARE YOU 18 YEARS OLD OR OLDER?

YesNo
CHOOSE SHIRT SIZE (ADULT SIZES ONLY)*
(EMAIL ADDRESS (EMAIL WILL SERVE FOR FASTER COMMUNICATION OF SCHEDULES, RULES, UPDATES, ETC.)*
example@example.com
COACH'S CLOSEST PUBLIC SCHOOL: *
IF CHILD IS PLAYING, PLEASE LIST CHILD'S NAME*
DRIVER'S LICENSE #
EXPIRATION DATE

MonthDayYear
Date
CLASSIFICATION
OCCUPATION
EMPLOYER
All ages are as of league start date
T-Ball:

Coed (ages 4-6)
Baseball

PeeWee - coach pitch (ages 7-8)Rookies - machine pitch (ages 9-10)Minor - kid pitch (ages 11-12)
Basketball

Coed Peewee (ages 5-7)Mini Mites (ages 8-10)Rookies (ages 11-13)
Soccer

Ages 5-6Ages 7-8Ages 9-10
Youth Flag Football

Ages 5-6Ages 7-8Ages 9-10
Youth Lacrosse

Ages 5-6Ages 7-8Ages 9-10Ages 10-11Ages 11-12Ages 12-14
You are NAYS Certified for selected sport on date:

MonthDayYear
Date
Please summarize your previous coaching experience (Glendale or other)
List any other experiences you have with voluntary or youth organizations
Do you have an ADA request for reasonable accommodations to perform your volunteer duties?

YesNo
Have you ever been terminated, discharged, or forced to resign?

YesNo
(If yes to the above, please name the employer, explain the circumstances, and when (mo/yr).
The City of Glendale conducts an extensive background investigation of criminal history. A criminal conviction does not constitute an automatic bar to volunteer placement. Each case is considered individually and based on volunteer requirements. However, failure to answer truthfully may result in disqualification for volunteer placement with the City of Glendale. “Crime” as used in this section means any and all felonies, misdemeanors, and serious driving offenses. “Crime” does not include minor civil traffic offenses. If you are unsure how to answer this question, please ask for clarification.

“Convicted” means that you have been found guilty by a court or jury, pleaded guilty or no contest to a crime and/or have been sentenced for a crime, whether incarcerated, placed on probation, fined, or received a suspended sentence.
Have you ever been convicted of a crime, regardless of whether the conviction was later set aside or expunged, in any domestic, foreign or military court?*

YesNo
Are you pending charges, trial or other court proceedings for any crime, in any jurisdiction, at this time?*

YesNo
If you answered yes to either or both of these questions, please give details including the offense(s) for which you were convicted or are currently pending charges, date of conviction, and jurisdiction (court, city, county and state). If an offense has been set aside or expunged, please give date of action.
Charge:*
Date:*

MonthDayYear
Date
Jurisdiction:*
CONDITIONS

I fully understand, acknowledge and agree to the following:

1). The program is under no obligation to accept all interested volunteers.

2). All statements made on this application are true and complete to the best of my knowledge. I understand that any omission, misstatement, or falsification may be cause for rejection of this application and/or discharge from volunteer service.

3). I authorize the City of Glendale’s Human Resources Department or its designee to make all necessary and appropriate investigations allowable by law to verify the information contained in this application.

4). Any or all of the following may be required before placement in any sensitive volunteer position: (A) Background Investigation, (B) Fingerprinting, (C) Substance Abuse Testing, and/or (D) MVD Check.
Volunteer Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: