Reapply Anderson

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Anderson COUNTY RETURNING YOKE FOLK & TEAM LEADER APPLICATION

Welcome back! Make sure you don't leave anything blank -- complete applications make up happy.

* Indicates required field

Name *

First

Last

Name you go by *

Email *

Phone Number *

Date of Birth *

Where do you attend church during the school year? *

Gender *

T-Shirt Size *

Category *

Address (Where you live during the school year) *

Line 1

Line 2

City

State

Zip Code

Country

Address (Where you get your mail, if different) *

Line 1

Line 2

City

State

Zip Code

Country

Club Status *

Stay at current club Need to change clubs

Certifications *

CPR First Aid Lifeguard

In the past 12 months, have you used alcohol, tobacco, illegal drugs, or abused prescription drugs? *

Yes No

Have you ever been arrested for or convicted of a criminal or juvenile offense? (If yes, please explain in the comments.) *

Yes No

Is there anything involving you or your background that would disqualify you from being entrusted with the supervision, guidance or care of youth? (If yes, please explain in the comments.) *

Yes No

Has your driver's license ever been suspended or revoked? (If yes, please explain in the comments.) *

Yes No

Have you ever been arrested for or convicted of child abuse or any related offense? (Is yes, please explain in the comments.) *

Yes No

Comment *

I understand that the information I have provided may be verified. I commit to participate in child protection training within 30 days if required. I affirm that the information I have given on this form is true and correct. By typing my name below, I acknowledge that I am electronically signing this application.

Type electronic signature here *

Submit

PO Box 3492 Knoxville, TN 37927
(865) 522-6907