Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
Cell Phone
E-mail

Date of Birth
Place of Birth
Drivers License Number
Social Security Number

Position you are applying for:  Head Coach or Assistant Coach Head Coach Assistant Coach

What age group are you interested in coaching? Midget 8 yr old 9 yr old 10 yr old 11 yr old 12 yr old 13 yr old 14 yr old

Do you currently have a child playing baseball in DRBA? Yes No

If so, what age will your child be on 04-30-08? Under 8 yrs old 8 yrs old 9 yrs old 10 yrs old 11 yrs old 12 yrs old 13 yrs old 14 yrs old

Has your child played baseball with another organization? Yes No

What level of play do you wish to coach? Midget Majors Level 0 AAA Level 1 AA Level 2 A Level 3

Have you coached baseball before?  Yes No

If so, when and where? 

Why do you want to coach in the DRBA? 

What coaching clinics for baseball have you attended in the last year? 

Please outline your coaching philosophy? 

Have you ever been asked to step down from a coaching/assistant position?  Yes No

Have you ever been convicted of a crime of violence or sexual assault on a child?  Yes No

Please include (3) professional or personal references name and phone number:

1. 2. 3.

I understand that in applying for a position to coach in the Dakota Ridge Baseball Association, DRBA will obtain a criminal History Report from any Law Enforcement agencies necessary.  I hereby give permission for any executive board member to review such report to evaluate my fitness to coach in the league.  I also agree that my team will be represented at all association meetings and that I will follow all the rules and regulations of the Dakota Ridge Baseball Association.  By clicking YES I agree that it is the same as my signature in agreeing with this statement, and that all answers on this application are true to the best of my knowledge.

  Must select one Yes No