Do not use forms from past years. Use extra paper to complete if additional space is required.
A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO COMPLETE THIS APPLICATION. Clement Su 6/7/13 Name __________________________________ date ___________________ 39712 Placer Way Address ________________________________________________________ Fremont CA 94538 City ____________________________ State _________Zip _____________ 623-78-9775 Social Security # (mandatory with LexisNexis or upon request) ____________________ (510) 388-6282 Cell Phone Business Phone e-mail Address: clementsu89@yahoo.com 01/28/13 date of Birth ____________________________________________________ Student Occupation _____________________________________________________ employer _______________________________________________________ Address ________________________________________________________ Special professional training, skills, hobbies: ___________________________ _______________________________________________________________ Community affiliations (Clubs, Service Organizations, etc.): _______________________________________________________________ Previous volunteer experience (including baseball/softball and year): _______________________________________________________________ do you have children in the program? Yes No s if yes, list full name and what level? _____________________________________________________ Special Certification (CPR, Medical, etc.): ______________________________ do you have a valid driver’s license: Yes No driver’s License#: ________________________________State ___________ Have you ever been convicted of or plead guilty to any crime(s): Yes No if yes, describe each in full:_________________________________________ _______________________________________________________________ Are there any criminal charges pending against you regarding any crime(s) involving s No if yes, describe each in full:______________ or against a minor? Yes __________________________________________________________________ Have you ever been refused participation in any other youth programs? Yes No s if yes, explain: ___________________________________________________ _______________________________________________________________ in which of the following would you like to participate? (Check one or more.) League Official Coach umpire field Maintenance Manager Scorekeeper Concession Stand Other
Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program: Name/Phone
Lan Mei/5103880781 ______________________________________________________________________
Home/5104906909 ______________________________________________________________________

Little League Volunteer Application -2013
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______________________________________________________________________ AS A CONditiON Of vOLuNteeRiNg, i give permission for the Little League organization to conduct background check(s) on me now and as long as i continue to be active with the organization, which may include a review of sex offender registries, child abuse and criminal history records. i understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. i hereby release and agree to hold harmless from liability the local Little League, Little League Baseball, incorporated, the officers, employees and volunteers thereof, or any other person