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Volunteer/Coach Enrollment Form
P.A.L. Volunteer/Coach Information
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* Indicates required question
Last Name, First Name:
*
Your answer
Address:
*
Your answer
City, State and Zip Code:
Your answer
Date of Birth (required for background check):
*
MM
/
DD
/
YYYY
E-Mail Address:
*
Your answer
Phone:
*
Your answer
Alternate Phone:
Your answer
Police Officer:
*
Yes (note department in next field)
No (if not, note in next field the name and department of the police officer sponsoring you)
What Department Do You Work For /Or Name And Department of Police Sponsor:
*
Your answer
What Aspect(s) Of The Program Are You Interested In:
Coaching
Assistant Coaching
Referring
Umpiring
Line Judging
Score Keeping
Hospitality
Maintenance
Fundraising
Other (explain below):
Other:
Note "other":
Your answer
What Sport(s) Or Activities Are You Interested In:
*
Basketball
Soccer
Football (Flag and Contact)
Boxing
Swimming/ Basic Water Survival
Volleyball
Baseball/Softball
Cheerleading
Bowling
Wrestling
Dance
Games (Electronic and Board Games)
Homework Help
Fishing
Archery
Yoga/Strength Training
Running/Track
Cooking Lessons
Horseback Riding/ Care for Horses
Gardening
Construction
Auto Repair
Other (note below):
Other:
Required
Other(s), Not Mentioned Above:
Your answer
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