PHOTO IDENTIFICATION
First Name
Middle Name, Initial
Last Name
Date
Address
City
State
Zip Code
Social Security # (Mandatory):
Cell Phone
Business Phone:
Home Phone:
E-Mail Address:
Date of Birth:
Occupation
Employer:
Employer Address:
Special professional training, skills, hobbies:
Community affiliations (Clubs, Service Organizations, etc
Previous volunteer experience (Including baseball/softball and year
If yes, list full name and what level?
If yes, list
Driver’s license
State
If yes, describe each in full: (If volunteer answered yes to Question 4, the local league must contact Little League International.)
If yes, describe each in full: Answering yes to Question 5, does not automatically disqualify you as a volunteer
If yes, describe each in full: Answering yes to Question 6, does not automatically disqualify you as a volunteer
If yes, explain: If volunteer answered yes to Question 7, the local league must contact Little League International.
In which of the following would you like to participate? (Check one or more.)
Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program:
Name / Phone
IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY OF THAT STATE’S BACKGROUND CHECK. FOR MORE INFORMATION ON STATE LAWS, VISIT OUR WEBSITE: LittleLeague.org/BgStateLaws
AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex offender registries (some of which contain name only searches which may result in a report being generated that 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 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 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.
If Minor/Parent Signature:
Applicant Name (please print or type):
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 disability.
Background check completed by league officer:
Review the Little League Regulation 1(c)(9) for all background check requirements
Please be advised that if you use JDP 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 receive a letter or email directly from JDP in compliance with the Fair Credit Reporting Act containing information regarding all the criminal records associated with the name, which may not necessarily be the league volunteer.
Only attach to this application copies of background check reports that reveal convictions of this application.
SUBMIT
