Board Application Please enable JavaScript in your browser to complete this form. - Step 1 of 8 Dear Prospective Board Member Thank you for your interest in volunteering for Carlisle Youth Football. The goal of our organization is to enrich the lives of young people by providing a safe and affordable football program, where participants will have fun and develop the values of leadership, sportsmanship, teamwork, and a commitment to hard work. We encourage and award scholastic achievement, competition, and playing well equally. Most will find this to be a very rewarding and fun experience. Our focus and priorities are player safety and character development. Yes, we want to WIN, but not at the expense of our integrity. We play well to maintain a reasonable level of competitiveness so that we get kids to come back season after season. What we do need is adult volunteers that are honest, open-minded to the game of football, reliable, good managers, people that know how to motivate children, and have an interest in the development of young people in their care. You do not have to be perfect to be a part of Carlisle Youth Football. However, we do have very high standards. We are looking forward to you being a part of the Carlisle Youth Football family! We thank you for considering us and this rewarding program. Sincerely, Carlisle Youth Football Board of Directors Next Board Member Application and Waiver Name *FirstLastHome Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCell Number *Work Number *Home NumberEmployer *Occupation *Employer Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeYears with Employer *-----123456789101112131415161718192021222324252627282930+BackNextVolunteer Experience *Do you have a certification in any sport? *YesNoHow many certifications to you currently hold?-----12345Organization *Member Number *Expiration Date * Organization 2 Organization 2 *Member Number 2 *Expiration Date 2 * Organization 3 Organization 3 *Member Number 3 *Expiration Date 3 * Organization 4 Organization 4 *Member Number 4 *Expiration Date 4 * Organization 5 Organization 5 *Member Number 5 *Expiration Date 5 *BackNextHave you taken concussion awareness training? *YesNoConcussion Awareness Expiration Date: *Are you one of the following? *EMTParamedicOther healthcare providerNone of the aboveOther healthcare provider: *Please indicate your professionAre you certified in any of the following? *First AidCPRAED TrainingOtherNone of the aboveOther Certifications *Please list all other certifications, including expiration date. First Aid Certification Expiration *CPR Certification Expiration *BackNextOther youth sports experience: *Please list all experiences you have had with youth sports. (Type N/A if you have none)Why do you want to volunteer? *BackNextDo you have a child in the program? *YesNoHow many children do you have registered with Carlisle Youth Football? *-----1234 Child 1 Child's Name *FirstLastChild's Age *-----45678910111213 Child 2 Child's Name *FirstLastChild's Age *-----45678910111213 Child 3 Child's Name *FirstLastChild's Age *-----45678910111213 Child 4 Child's Name *FirstLastChild's Age *-----45678910111213BackNextWhat positions are you considering? *What other skills do you have that may add value to our youth football organization? *Current Memberships (Community, Religious Based, Business, Labor or Professional)BackNext Additional Information Have you ever been arrested? *YesNoIf yes, please explain: *Have you ever harmed a child? *YesNoIf yes, please explain: *Have you ever been convicted of a crime? *YesNoIf yes, please explain: *Have you ever been asked to leave a program? *YesNoIf yes, please explain: *Have you ever been ejected from a game as a coach or spectator? *YesNoIf yes, please explain: *Do you use illegal drugs? *YesNoIf yes, please explain: *Other than the above, is there any fact or circumstance that would call into question your being entrusted with the supervision, guidance, or care of young people? *YesNoIf yes, please explain: * My signature below acknowledges that I hereby certify the facts set forth in this Board Member Application are true and correct to the best of my knowledge. I understand that if I falsify statements on this Board Member Application, I may not be considered for the Carlisle PeeWee Football Board. I hereby authorize the Carlisle PeeWee Football program, or its representative, to conduct an investigation into my background history to verify the above information. I also understand the final selection of board members is the sole discretion of the Carlisle PeeWee Board. Further, I will abide by all rules, policies, and by-laws of the League and that my actions can be held accountable to any and all of the aforementioned and that I can be suspended, placed on probation, or removed from the Carlisle PeeWee Football Board per their rules and by-laws. Signature *Clear SignatureSubmit