Port Neches Groves Youth Football Association
Coaching Application
Personal Info:
Name: _______________________________________________________
Address: _______________________ City: ____________ State: _______
Phone: __________________ E-mail: ____________________________
Employer: _____________________________________________________
Circle which position(s) you are interested in applying for:
Head Coach Asst. Coach Special Teams
MPR/Sideline Cheer Coordinator Cheer Aide
Name and Division of your child in the football program:
_____________________________________________________________
Please answer the following:
1) What is important to you as a youth sports coach?
2) What is your experience with coaching youth sports and how many years have you been coaching?
3) What is your personal philosophy toward coaching a youth sports team?
4) What knowledge do you have about the Port Neches Groves Football program?
5) What certifications, if any, do you currently have? (First-Aid, CPR, etc.)
6) Why do you feel like you would be the most qualified candidate for this coaching program?
7) Please list any experience you may have had personally with the game of football, i.e. whether you played in high school, college, or another league/division.
REFERENCES
Personal
Name: _____________________________ Phone: _____________________
Business
Name: _____________________________ Phone: _____________________
I agree that in the course of considering my application, you may inquire to verify information considering my background including educational, criminal and employment. I authorize educational institutions and references listed above to give you any and all information concerning my education and fitness to work with children and young people. I further agree to release and hold harmless PNGYFA and STJFL, references and law enforcement from all liability and any damage that may result from releasing this information to you and or volunteering at on behalf of PNGYFA. I understand that photographs/video tapes may be made of my volunteer activities. I authorize the PNGYFA and STJFL without limitations, to copy, publish and distribute such photographs/videotapes. I waive all claims I may have against your organization and/or its agents, subsidiaries or assignees related to the above photos/videotapes. I am aware that the PNGYFA and STJFL will run a criminal background check.
___________________________________ ____________________
Signature Date
Background Check Form
I understand that in connection with my application for employment, volunteer work, and/or for continuous employment, and/or lounger work that PNGYFA, STJFL, their agents or any other authorized third parties (collectively, the “Investigators:”) may be performing, requesting, obtaining or conducting a background check on me. This background check may include an inquiry into my employment history, education, general character or reputation, work experiences, driving, and/or criminal history. However, unless my position involves handling money and/or other transferable monetary instruments, my credit history will not be checked. I understand that PNGYFA and STJFL may rely on any part or all of this information in determining whether to extend an offer of employment/volunteers’ duties to me. I further understand that if any adverse action is taken by, or if the PNGYFA and STJFL choose not to extend an offer of employment/duties to me based upon the information, that I will be provided a copy of such information along with a summary of my rights under the Fair Credit Reporting Act. I understand that the background check, which may be performed by Investigators, is being performed as part of the process to evaluate me prior to employment/volunteer and is not conducted for any purpos other than in connection with my application for employment and/or my eligibility for continued employment/volunteer duties. I have read this Pre-Employment and Continued Employment/Volunteer Disclosure and by signing below, hereby authorize Investigators to conduct a background check as described herein in conjunction with my application for employment/volunteer duties. I hereby release any and all Investigators, including PNGYFA and STJFL, from any and all liability related to the procurement or disclosure of any information provided by me or obtained about me in connection with my application with PNGYFA and STJFL. I further direct and authorize Investigators to conduct the background check and further authorize any third parties who may be the custodians of or in possession of the requested information, to disclose such information to Investigators in connection with this background check. Although furnishing your Social Security Number is optional, it shall be used for NO other purpose other than to make the process for conducting a background search more accurate. It shall not be sold, or in any way transferred to a third party except for the express purpose of conducting the background check.
Application Signature ____________________________________________
Printed Name ______________________________ Date _______________
Social Security Number ______-_____-______ Date of Birth _____________
Former Last Name (if applicable) ______________________________
Current Address:
________________________________________________________________
Street City State Zip
Former Address:
________________________________________________________________
Street City State Zip