Hudson Litchfield Youth Football & Cheer, Inc.

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2023 Board Position Application

* Applicant's Name:

* Board Position Selection:

Field Manager 1

Field Manager 2

Equipment Manager 2

* Cell Phone number:

* Email Address:

Instructions:

1. Type of position you are applying for. *Registration #s will determine what teams are fielded*
2. Team you are interested in Coaching.
3. Please make sure to complete all questions.

Disclaimer:
The information submitted in this form will be kept confidential and is for internal use by the HLYFC, Inc. only. It will not be distributed to anyone outside this organization.

Personal Information

* First Name:

* Last Name:

* Middle Intial:

* Date of Birth:

Residence

* Current address:

* City:

State:

* Zip code:

References

Please list persons familiar with your character:

* Name:

* Phone number:

* Name:

* Phone number:

Additional Information

* 1. Have you ever been convicted of a crime? (If yes, explain below) :

* 2. Have you ever been charged with child neglect or abuse?:

* 3. Has your drivers license ever been suspended?:

* 4. Are there any facts or circumstances involving you or your background that would call into question your being entrusted on the board?:

If yes to any questions above please explain:

I understand that

The information that I have provided may be verified, by contacting persons or organizations named in this application, or by contacting any person or organization that may have information concerning me. I hereby release and agree to hold harmless from liability any person or organization that provides information. I also agree to hold harmless the association, its officers and volunteers.

* Electronic Signature:

* Date:

In signing this application, I affirm that the information I have given is true and correct.

* Electronic Signature:

* Date:

* indicates required fields

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2023 Board Position Application