Form 1008 "Coaches Application" - City of Bremen, Georgia (United States)

What Is Form 1008?

This is a legal form that was released by the Georgia Department of Natural Resources - a government authority operating within Georgia (United States). The form may be used strictly within City of Bremen. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

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Download Form 1008 "Coaches Application" - City of Bremen, Georgia (United States)

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Form 1008
BREMEN PARKS & RECREATION DEPARTMENT
I understand that becoming a volunteer coach, I will be governed by rules and policies of the
Bremen Parks & Recreation Department and the league in which the Department is participating.
This includes my becoming certified before the first game which I will be coaching. This also
means that I am aware that I must adhere to the coaching ethics policies by this position.
1.
Name:_____________________________________Date Application_____________________
Address_____________________________________Email: ____________________________
Street
City
ZIP
Phone Number(h)____________________(w)__________________©)____________________
2.
Sport to be Coached _______________________________Age Preferred_________________
3.
Will your child/children be participating in this program _________, if yes how many and
what ages____________________________________________________________________
4.
Total years coached this sport _________ This age group_______Other__________
List any playing experience you have had in this sport:
______________________________________________________________________________
______________________________________________________________________________
5.
Coaching experience with Bremen Parks & Recreation Department
Sport__________________________________Age_________
Sport _________________________________ Age ________
Sport _________________________________ Age ________
6.
Have you coached an All-Star team previously? Please list:
_____________________________________________________________________________
7.
Why do you want to coach?
_____________________________________________________________________________
_____________________________________________________________________________
8.
Will you be available for coaches meetings?_______
9.
If you have had previous training, please specify the program and your certification
number
Training _______________________________________Certification #________________
10.
Are you willing to coach other age groups?_______
If so, what ages_____________
11.
Why do you feel you would make a good coach? ________________________________
__________________________________________________________________________
If chosen as head coach, who would you recommend as your assistant coach?
_________________________________________________________________________________
I have read and answered all the above questions to the best of my knowledge and I agree to do
what is best for the children participating in this program while coaching for this department.
Signature:___________________________________________Date________________________
COMPLETION OF THIS APPLICATION DOES NOT GUARANTEE A TEAM/SQUAD
Form 1008
BREMEN PARKS & RECREATION DEPARTMENT
I understand that becoming a volunteer coach, I will be governed by rules and policies of the
Bremen Parks & Recreation Department and the league in which the Department is participating.
This includes my becoming certified before the first game which I will be coaching. This also
means that I am aware that I must adhere to the coaching ethics policies by this position.
1.
Name:_____________________________________Date Application_____________________
Address_____________________________________Email: ____________________________
Street
City
ZIP
Phone Number(h)____________________(w)__________________©)____________________
2.
Sport to be Coached _______________________________Age Preferred_________________
3.
Will your child/children be participating in this program _________, if yes how many and
what ages____________________________________________________________________
4.
Total years coached this sport _________ This age group_______Other__________
List any playing experience you have had in this sport:
______________________________________________________________________________
______________________________________________________________________________
5.
Coaching experience with Bremen Parks & Recreation Department
Sport__________________________________Age_________
Sport _________________________________ Age ________
Sport _________________________________ Age ________
6.
Have you coached an All-Star team previously? Please list:
_____________________________________________________________________________
7.
Why do you want to coach?
_____________________________________________________________________________
_____________________________________________________________________________
8.
Will you be available for coaches meetings?_______
9.
If you have had previous training, please specify the program and your certification
number
Training _______________________________________Certification #________________
10.
Are you willing to coach other age groups?_______
If so, what ages_____________
11.
Why do you feel you would make a good coach? ________________________________
__________________________________________________________________________
If chosen as head coach, who would you recommend as your assistant coach?
_________________________________________________________________________________
I have read and answered all the above questions to the best of my knowledge and I agree to do
what is best for the children participating in this program while coaching for this department.
Signature:___________________________________________Date________________________
COMPLETION OF THIS APPLICATION DOES NOT GUARANTEE A TEAM/SQUAD
- BREMEN POLICE DEPARTMENT
121 PACIFIC AVENUE, BREMEN, GEORGIA 30110
CITY OF BREMEN
232 TALLAPOOSA STREET, BREMEN, GEORGIA 30110
DEPARTMENT OF PARKS & RECREATION DEPARTMENT
417 RIVER CIRCLE
BREMEN, GEORGIA 30110
I HEREBY AUTHORIZE THE BREMEN POLICE DEPARTMENT TO RELEASE ANY
CRIMINAL HISTORY RECORD INFORMATION PERTAINING TO ME WHICH MAY
BE IN THE FILES OF ANY STATE OF LOCAL CRIMINAL JUSTICE AGENCY.
______________________________________
_______________
PRINT FULL NAME
DATE:
ADDRESS:___________________________________________________________________________
CITY:_______________________________STATE:___________________ ZIP CODE:_____________
DATE OF BIRTH: ______/_______/_________
SOCIAL SECURITY: ________-_______-__________
SEX:______________
RACE:_____________
______________________________________________
Applicant’s Signature
PERSON REQUESTING RECORD SIGNATURE:_______________________________________________
PRINT NAME, AGENCY, COMPANY, AND TITLE OF REQUESTOR:
___________________________________________________________________________________
SWORN AND SUBSCRIBER TO ME THIS ___________DAY OF
___________________________, 20______.
__________________________________________________
NOTARY PUBLIC
MY COMMISSION EXPIRES: ___________________________
NOTICE:
ONCE A SIGNED AND NOTARIZED REQUEST IS GIVEN TO THE BREMEN POLICE DEPARTMENT AND A CRIMINAL RECORDS CHECK IS PERFORMED, THE RECORD
INFORMATION WILL ONLY BE DISSEMINATED TO THE PERSON MAKING THE REQUEST. THE DISSEMINATION OF INFORMATION IS REGULATED BY GEORGIA CODES,
O.C.G.A. 35-3-34 AND 35-3-35. ONCE THIS INFORMATION IS DISSEMINATED BY THE BREMEN POLICE DEPARTMENT, IT IS THE REQUESTER’S RESPONSIBILITY TO
COMPLY WITH GEORGIA LAW PERTAINING THE RECORD SHEET. UNDER PENALTY OF LAW, O.C.G.A. 35-3-38, A PERSON COULD FACE UP TO 2 YEARS IN PRISON
AND/OR A $5000.00 FINE FOR IMPROPER DISSEMINATION OF CRIMINAL RECORDS. THE BREMEN POLICE DEPARTMENT, ITS EMPLOYEES AND ADMINISTRATORS ARE
NOT RESPONSIBLE FOR THE ACCURACY OF THE RECORD RETRIEVED FROM THE GEORGIA CRIME INFORMATION CENTER NOR FOR ITS DISSEMINATION AFTER IT IS
GIVEN TO THE REQUESTER UNDER SEAL.
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