Criminal History Form
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BELTON TIGER YOUTH FOOTBALL LEAGUE (BTYFL)
CRIMINAL HISTORY RECORD INFROMATION ADDENDUM
The Belton Tiger Youth Football League is required by the BTYFL Bylaws, Article VI, Section 1 to review the criminal history of applicant volunteers. The information requested below is necessary to obtain criminal history record information.
PLEASE PRINT:
Full Name ____________________________________________________________________
Last First Middle Maiden/Other
Social Security Number _________________________ Date of Birth _______/______/_____
Driver’s
License_______________________________________________________________
State and Number
Mailing Address _______________________________________________________________
Street City State Zip
Sex: Male Ethnicity: Black
Female White/Other
Position applied for ____________________________________________________________
I understand that the information I am providing about age, sex and ethnicity will not be used to determine eligibility to volunteer but will be used solely for the purpose of obtaining criminal history record information.
Signature _____________________________________________________________________
Date _________________________________________________________________________