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WYFFL CORI Volunteer Application - 2010

Mail to: W.Y.F.F.L, P.O. Box 689 Holden, MA 01520

Do not use forms from past years.

Use extra paper if  required.

A PHOTO COPY OF A  VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION

MUST BE ATTACHED TO COMPLETE THIS APPLICATION.

Please Print Neatly 

Name:

Date:

Address:

City: 

State:

Zip:

Home:

Cell:

Work:

E-mail Address:

Date of Birth:

Social Security # (optional; mandatory upon request): 

Employer:

Occupation:

Address:

Special professional training, skills, hobbies:

Community affiliations (Clubs, Service Organizations, etc.):

Previous volunteer experience (including baseball/softball and year):

Do you have children in the program?     Yes      No  

If yes, list full name(s) and what level:

Special Certification (i.e. CPR, Medical, etc.):

Do you have a valid driver’s license:    Yes      No                         Driver’s License #:                                                                     State:

Have you ever been convicted of or plead guilty to any crime(s):     Yes      No

If yes, describe each in full:

Have you ever been refused participation in any other youth programs?     Yes      No

If yes, explain:

In which of the following would you like to participate? (Circle one or more.) 

Head Coach

Assistant Coach

Down Markers and Chains

Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program:

Name:

Phone:

Name:

Phone:

Name:

Phone:

As a condition of volunteering, I give permission for WYFFL to conduct a background check on me, which may include a review of sex offender registries, child abuse and criminal history records. I understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability WYFFL, the officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous appointments, WYFFL  is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension by the President and removal by the Board of Directors for violation of ANY AND ALL policies or principles.

Applicant Signature

Date:

Applicant Name (please print or type): 

NOTE: WYFFL will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

Local League Use Only:

Background check completed by league officer on System)s) used for background check (minimum of one must be checked):

Sex Offender Registery Criminal History Records *Choicepoint *Please be advised that if you use Choicepoint and there is a name match in the few states where only name match searches can be performed you should notify volunteers that they will compliance with the Fair Credit Reporting Act compliance with the Fair Credit Reporting Act containing information regarding all the criminal records associ­ated with the name, which may not necessarily be the league volunteer. Only attach to this application copies of background check reports that reveal convic­tions of this application.

rev. 9/08                                                                                                                                                                                                             01-073-05