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SAY Volunteer - Risk Management Form

Thank you for using the Cincinnati Hills SAY Soccer Online SAY Volunteer and Risk Management Form. Please enter the required fields(*) below and press the Submit button on the bottom of the form.

SAY Volunteer Application
Please PRINT all information. Fields identified with an (*) are required
Applicant Information
*First Name:
MI:
*Last Name:
*Current Address:
*Years Lived at Current Address:
*City:
*State:
*Zip Code:
*Home Phone:()--
*Work Phone:()--
*Date Of Birth: (mm/dd/yyyy)
*Drivers License #:
*State Issued:
*Expiration Date: (mm/dd/yyyy)
*Social Security Number:-- (301-111-5555)
Cinn Hills SAY District:
Personal History Information
The following must be completed by all volunteers, new and returning.
Have you ever been found guilty by a court or other tribunal to have committed a violent act against another person, engaged in any misconduct involving a juvenile OR been convicted of a crime except for a minor traffic violation. YES NO 
Returning Volunteer - Check one: My personal history HAS HAS NOT changed since last year.
Notice of Consent to Criminal Background Check
Soccer Association for Youth (SAY), at its discretion, may use the above information to conduct a criminal background check regardless of the response on "Personal History."
As an applicant for a SAY Volunteer position, I hereby attest to the truthfulness of the representations I have made, including the information provided in reponse to the questions regarding my criminal history. I authorize SAY to verify the above information and waive any right to confidentiality with respect to the information requested. If requested by SAY, I will submit my fingerprints for that purpose.
Signature of Applicant:
(by checking this box you indicate you have caused this form to be electronically submitted)
Date:2/4/2012
 
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