Little League Volunteer Application Form - 2016
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1Little League
Volunteer Application - 2016
®
Do not use forms from past years. Use extra paper to complete if additional space is required.
A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE
Please list three references, at least one of which has knowledge of your participation as a
ATTACHED TO COMPLETE THIS APPLICATION.
volunteer in a youth program:
Name __________________________________ Date ___________________
Name/Phone
Address ________________________________________________________
______________________________________________________________________
City ____________________________ State _________Zip _____________
______________________________________________________________________
Social Security #
_______________
(mandatory with First Advantage or upon request)
______________________________________________________________________
Cell Phone
Business Phone
IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY
Home Phone: _____________
E-mail Address:
OF THAT STATE’S BACKGROUND CHECK. FOR MORE INFORMATION ON STATE LAWS, VISIT OUR WEBSITE:
Date of Birth ____________________________________________________
Occupation _____________________________________________________
AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background
Employer _______________________________________________________
check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex
Address ________________________________________________________
offender registries (some of which contain name only searches which may result in a report being generated that
Special professional training, skills, hobbies: ___________________________
may or may not be me), 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 the local Little League, Little League Baseball, Incorporated, the officers, employees
Community affiliations (Clubs, Service Organizations, etc.):
and volunteers thereof, or any other person or organization that may provide such information. I also understand
_______________________________________________________________
that, regardless of previous appointments, Little League is not obligated to appoint me to a volunteer position. If
Previous volunteer experience (including baseball/softball and year):
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 Little League policies or principles.
_______________________________________________________________
Applicant Signature _______________________________________ Date _________
Do you have children in the program? Yes
No
If yes, list full name and
what level? _____________________________________________________
If Minor/Parent Signature___________________________________Date __________
Special Certification (CPR, Medical, etc.): ______________________________
Applicant Name(please print or type) _______________________________________
Do you have a valid driver’s license: Yes
No
NOTE: The local Little League and Little League Baseball, Incorporated will not discriminate against any
person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or
Driver’s License#: ________________________________State ___________
disability.
Have you ever been convicted of or plead guilty to any crime(s) involving or against
a minor?:
Yes
No
LOCAL LEAGUE USE ONLY:
If yes, describe each in full: _________________________________________
Background check completed by league officer ________________________________
_______________________________________________________________
on ____________________________________________________________________
Are there any criminal charges pending against you regarding any crime(s) involving
or against a minor?
Yes
No If yes, describe each in full:______________
System)s) used for background check (minimum of one must be checked):
__________________________________________________________________
Have you ever been refused participation in any other youth programs? Yes
No
Sex Offender Registry
Criminal History Records
*First Advantage
If yes, explain: ___________________________________________________
*Please be advised that if you use First Advantage 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
In which of the following would you like to participate? (Check one or more.)
receive a letter directly from LexisNexis in compliance with the Fair Credit Reporting Act containing
information regarding all the criminal records associated with the name, which may not necessarily
League Official
Coach
Umpire
Field Maintenance
be the league volunteer.
Manager
Scorekeeper
Concession Stand
Other
Only attach to this application copies of background check
reports that reveal convictions of this application.
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