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TCBA Coach Background Check Form
*First Name
Enter Full Legal Name
*Last Name
*Middle Name
*Address
Example - 123 Main St
*City
*State
*Zip Code
*Home Phone
Example: 817-555-5555
*Work Phone
Example: 817-555-5555
Cell Phone
Example: 817-555-5555
*Email Address
Example: joe@abc.com
*Drivers License Number
*State where DL issued
State Your DL issued?
*Birthdate
Example: 01/01/1975
*Social Security Number
Example: 123-45-6789
COACHING INFORMATION
Please check all that apply:
Umpire
Board Member
Coach
What age(s) are you coaching?
'38' '99'
Choose all that apply
4U - Rookie T-Ball
6U - T-Ball
8U - Coach Pitch
10U - Kid Pitch
12U - Kid Pitch
14U - Kid Pitch
Use Control Key for multiple
Team Name(s)?
COACHING EXPERIENCE
Please list ANY coaching experience even if outside TCBA
Head Coach
Number Of Years
1
2
3
4
5
6
7
8
9
10+
League / Division(s) / Team
Assistant Coach
Number Of Years
1
2
3
4
5
6
7
8
9
10+
League / Division(s) / Team
Has TCBA ever taken disciplinary action against you for any reason?
No
Yes
If Yes, please explain
Do you agree to be financially responsible for any league issued equipment?
No
Yes
*****YOU MUST CLICK HERE TO READ THE TCBA BACKGROUND SCREENING POLICY*******I certify that I have read and agree to the conditions set forth by the Tri-Cities Baseball Association regarding coaches background checks. I also agree to allow First Check Applicant Screening to conduct an investigative background check report on me on behalf of Tri-Cities baseball.
*Type Your Full Name Here
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