2011 Competitive Coach Application

Please complete this form, then print, sign, and mail to: GEYL, 6501 W 20th Street, Greeley, CO 80634 before July 15, 2010

First Name
Last Name
Date of Birth
Address
City	State Zip
Email Address
Phone Number

I would like to coach a(n)

Social Security Number
Are you a US Citizen?
Have you ever been convicted of a felony?
Have you ever been ejected or asked to leave a sports facility as a spectator, parent, coach or participant?

Please document your previous coaching experience:

Year	Team	Sport
Year	Team	Sport
Year	Team	Sport
Year	Team	Sport
Year	Team	Sport
Year	Team	Sport
Year	Team	Sport
Year	Team	Sport

I certify that all statements made in this application are true and complete to the best of my knowledge. I hereby release all persons and references from any and all liability arising from giving or receiving information about my qualifications. I understand that any false answers of statements or misrepresentations by omission made by me as part of my application will be sufficient grounds for rejection of my application or my immediate suspension, should one be discovered after I am coaching a team. Greeley Evans Youth League, Inc. reserves the right to do background checks (including local, state and national law enforcement) as needed or deemed necessary. I hereby acknowledge that I have read, understand and agree to the preceding statements.

Signed__________________________________________Dated_______________

Last Updated on Tuesday, 22 June 2010 22:05