Live Oak Jaguars

Live Oak Jaguars

P.O. Box 73, Universal City TX 78148

COACH/VOLUNTEER APPLICATION FORM

(print and fill-out then mail form to address above)

I.Position for which you are applying:

Head Football Coach ______Assistant Football Coach ______
Cheerleading Coach ______Team Mom/Dad ______
Volunteer ______Other ______

II.Personal Information

Name:
______
Last / ______
First / ______
Middle
Other names used:
______
Last / ______
First / ______
Middle
Street Address:
______/ City:
______/ State and Zip:
______
Home Phone:
______/ Work Phone:
______/ Cell Phone:
______
S.S. Number:
______/ Drivers License No. and State
______/ Date of Birth:
______
E-mail address:
______/ Occupation:
______/ Employer:
______

A. Please list children participating:

Name: ______Age: ______Activity:______

Name: ______Age: ______Activity: ______

B. Coaching Experience:

1. Please indicate below your coaching/volunteering experience: (circle one) Football or Cheerleading

LevelPosition YearTeam NameOrganization

Flag ______

Midgets ______

Rookies ______

Juniors ______

Seniors ______

Varsity ______

Other:

______

3. Do you have any Special Certification (i.e. CPR, Medical, etc.)? If yes, please explain below: ______

______

C.For first time applicants: Please attach a separate sheet of paper describing your experience and qualifications for the position sought. Be sure to include participation, coaching, and instructional experience in the area. Tell us why you are interested in coaching/volunteering and describe your philosophy in coaching/volunteering.

D.1.Have you ever been convicted of any crime involving or against a minor?

_____ Yes _____No If yes, please explain details on a separate sheet of paper.

2.Have you ever plead guilty to or been convicted of any felony crime? _____Yes _____No

If yes, please explain on a separate piece of paper.

Have you ever been refused participation in any other youth programs?

_____Yes _____No If yes, explain on a separate piece of paper.

E.List personal references not related to you:

name / affiliation / home phone / work phone / years known
1.
2.
3.

Authorization and Release

As a condition of volunteering, I give permission for Live Oak Jaguars (LOJ), its officers, directors, and agents to conduct a background check on me, which may include a review of sex offender registries, child abuse and criminal history records and reference checks. I understand that if appointed, my position is conditional upon LOJ receiving no inappropriate information on my background. I authorize any person or organization to provide any information described above to LOJ. I hereby release and agree to hold harmless LOJ, or any other person or organization that may provide such information from any and all liability and claims arising out of or relating to disclosure or use of such information.

I understand that regardless of previous appointments, I may not be appointed to a position and that LOJ reserves the right to deny this Application within its sole discretion. If appointed I understand that at any time I am subject to termination at the discretion of LOJ. I agree, if appointed, to conduct myself in accordance with the rules and regulations of LOJ, the Texas Youth Football Association (TYFA) and any other governing organizations.

I affirm that the information set forth above is complete, true and correct and that I have not knowingly withheld any factor or circumstance that would affect my application. I understand that any false information submitted in the application may result in my denial of this Application or discharge. I also agree that as long as I remain a volunteer, LOJ may repeat the criminal history records check at any time.

Signature: ______

Date: ______

LOJ Use Only:

Background check ______