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 _________________________________________________________________________