YOUTH SPORTS HEAD COACH APPLICATION

NAME

First Name Last 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

City State / Province

Postal / Zip Code

ARE YOU 18 YEARS OLD OR OLDER?

Yes No

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

Date

CLASSIFICATION

OCCUPATION

EMPLOYER

All ages are as of league start date

T-Ball:

Coed (ages 4-10)

Baseball

PeeWee - coach pitch (ages 6-8) Rookies - machine pitch (ages 8-10) Minor - kid pitch (ages 10-12) Major - kid pitch (ages 12-14)

Football

Peewee (ages 7-9) Rookies (ages 10-12)

Softball

Ponytail - coach pitch (ages 6-8) Cholla -machine pitch (ages 8-10) Ocotillo - slow pitch (ages 10-12)

Basketball

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

You are NAYS Certified for selected sport on date:

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?

Yes No

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

Yes No

(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?

Yes No

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

Yes No

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:

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