2010 WCRA Coach / Advisor Application Form

When you complete and submit the form, the link will ask you to "Return to the Form".

Click "Return to the Form", then Click here.

APPLICATION FOR:

Head Football Coach             Head Cheer Advisor

Assistant Football Coach      Assistant Cheer Advisor

PERSONAL

NAME:

ADDRESS:

CITY:     STATE:     ZIP:

HOME PHONE:     WORK PHONE:

EMAIL:     SSN:

DRIVER'S LICENSE NUMBER:

REFERENCES (list 3 not related)

REFERENCE 1:

REFERENCE 2:

REFERENCE 3:

EMPLOYMENT HISTORY

PRESENT EMPLOYER:

NAME OF SUPERVISOR:

ADDRESS:

CITY:     STATE:     ZIP:

DATES OF EMPLOYMENT:

* PROOF OF AUTOMOBILE INSURANCE IS REQUIRED TO MEET OHIO STATE MINIMUM REQUIREMENTS.

HAVE YOU EVER BEEN ARRESTED, CHARGED OR CONVICTED OF A CRIME TO INCLUDE BUT NOT LIMITED TO DUI, OTHER ALCOHOL RELATED OFFENSES, MISDEMEANOR OFFENSES AND ALL FELONIES? IF YES, EXPLAIN:

HAVE YOU EVER BEEN INVOLVED IN AN INCIDENT INVOLVING CHILD ABUSE OR NEGLECT? IF YES, EXPLAIN:

HAVE YOU EVER HAD OR DO YOU HAVE A PROBLEM WITH DRUGS AND/OR ALCOHOL? IF YES, EXPLAIN:

REASON FOR WANTING TO VOLUNTEER:

WHAT INTERESTS YOU ABOUT THIS POSITION?:

WHAT EXPERIENCE DO YOU HAVE WORKING WITH CHILDREN?:

LIST THE SPORTS YOU HAVE COACHED:

LIST ANY FORMAL TRAINING YOU HAVE RECEIVED IN COACHING:

LIST ANY FORMAL TRAINING YOU HAVE RECEIVED IN FIRST AID:

LIST ANY FORMAL TRAINING YOU HAVE RECEIVED IN TEACHING CHILDREN OR PARENTING:

WHAT ARE YOUR PLANS FOR AN EDUCATIONAL AND RECREATIONAL YEAR FOR THE CHILDREN OF WCRA?:

AS AN APPLICANT, I REALIZE THAT A BACKGROUND CHECK WILL BE CONDUCTED ON ALL COACHES AND ADVISORS AND THEREBY WAIVE ANY AND ALL PRIVACY RIGHTS PURSUANT TO OHIO AND FEDERAL STATUTES. BY SIGNING THIS APPLICATION, I AGREE TO ALLOW THE WCRA TO CONDUCT THIS CHECK. I ALSO AGREE THAT IN THE EVENT OF AN UNFAVORABLE FINDING, I WILL NOT BE CONSIDERED FOR THE POSITION APPLYING FOR.

BY APPLYING FOR SAID POSITION I HEREBY UNDERSTAND THAT THERE EXIST NO APPEAL RIGHTS IF I AM NOT SELECTED.

TODAY'S DATE:

SIGNATURE / SUBMISSION: