Coaching Application

Subject

(1) Applicant Name

(2) Phone Number

(3) Street Address

(4) City / State / Zip

(5) Position Requested

(6) Coach Status (select one)

(7) If approved, I would like to Manage/Coach with:

(8) House Only: In which age division are you requesting to Manage and/or Coach? (select one) (note: you must complete an application for each age division you plan to Manage/Coach in.

(9) Travel Only: In which age division are you requesting to Manage and/or Coach? (select one) (note: you must complete an application for each age division you plan to Manage/Coach in.

(10) Briefly outline your prior experience managing and/or coaching youth sports programs. Please provide the organization name, the sport, the year(s) and position(s) held

(11) In the last five years as a coach, manager or parent, have you ever been removed or ejected from a youth sports game or activity by the umpire or officials?

(12) In the last 5 years as a coach, manager or parent, have you been suspended from your youth coaching/managing duties by the local or state governing youth sports organizations or athletic association?

(13) In any prior manager/coach position held in any youth sport, have any formal complaint and/or disciplinary actions been brough against you?

(14) To comply with Little League, I hereby authorize/agree to a background check.

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