SCOTT COUNTY YOUTH BASEBALL
APPLICATION FOR COACHING
PART A: Personal Information
NAME: (please print) ________________________________________________________________________________
ADDRESS: _______________________________________________________________________________________
CITY: ________________________________________ ZIP CODE: _________________________________________
HOME PHONE: ___________________ WORK PHONE: ___________________ CELL PHONE: ___________________
EMAIL: _____________________________________ EMPLOYER: _________________________________________
(Applicants must complete and submit a KY State Background check through Scott County Parks and Recreation Department. Additionally, all head
coaches must take and pass the online coaches certification provided through Cal Ripken/Babe Ruth at their own expense. www.baberuthcoaching.org)
PART B: Desired Coaching Position
POSITION:
Head Coach
LEAGUE:
Senior
Assistant Coach
LEAGUE:
Training
Major
Rookie
Minor
T-Ball
PART C: Playing, Coaches Training and Experience
Number of years Coaching YOUTH team sports ___________ (Sports) ________________________________________
Number of years experienced as a baseball head coach _________
Number of years experience as a baseball assistant coach ________
Did you coach in SCYB in spring 2015 season?
Team ___________________
Have you ever been dismissed OR disciplined as a coach?
Yes
League________________________
No
If yes, please explain: ________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
I hereby certify that all information given by me in the above application is true and accurate to the best of my
knowledge. I understand that false or misleading information or consequential omission of any type may lead to
my not being accepted as a coach or for my dismissal regardless of when discovered.
Signature: _________________________________________________ Date: _________________________________
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