CASV-Coach Resume Form
Cooperstown All Star Village
P.O. Box 670
Cooperstown, NY 13326
Coach Resume Form
Team and Coach Information:
Team Name: _______________________________________________ Week Attending CASV: ________________________
Name: _________________________________________________ Date of Birth:_________________ SSN:_______________
( Must be 18 years or older )
Address: ________________________________________________________________________________________________
City: _________________________________________________ State:________________ Zip Code:___________________
Home Phone: ____________________________________ Business Phone: ________________________________________
Occupation:________________________________ Name of Employer:_____________________________________________
Address: ________________________________________________________________________________________________
City: _____________________________________________ State:____________________ Zip Code:___________________
Have you ever been convicted of a felony or have a pending criminal action against you? Yes o No o
If yes, please describe in detail: _______________________________________________________________________________
______________________________________________________________________________________________________________________
List 3 (three) references please include references that have knowledge of your Coach status (please print clearly and
legibly):
Reference Name: Reference Phone Number:
1) ________________________________________________ ___________________________________________________
2) ________________________________________________ ___________________________________________________
3) ________________________________________________ ___________________________________________________
Community Affiliations (Organizations, Churches, etc.):
______________________________________________________________________________________________________________________
Previous Experience (Scouting, Youth Org., Coaching, etc.):
______________________________________________________________________________________________________________________
Special Certifications (Medical, Emergency Services, CPR, etc.):
______________________________________________________________________________________________________________________
As a condition of being a coach at Cooperstown All Star Village (CASV), I give CASV permission to conduct a background check, which
may include a review of sex offender registries, child abuse and criminal records. I understand that, if accepted, my status is conditional
upon CASV receiving no inappropriate information. I hereby release and agree to hold harmless from liability Cooperstown All Star
Village, the officers, employees or any other person or organization that may provide such information. I understand that I am subject to
suspension and removal by CASV for violation of any Cooperstown All Star Village rules or Policies.
I, ____________________________ do certify under penalty of perjury that the above information is complete and accurate.
(please print name)
Coach Signature: ______________________________________________________ Date: ___________________________
For use by Cooperstown All Star Village Only:
This Coach Resume was reviewed and completed by:
Signature of Director: ___________________________________________________ Date: __________________________________
Resume Templates 1210 Document(s)
