This volunteer application should only be used if a league is manually entering information into JDP
or an outside background check provider that meets the standards of Little League Regulations 1(c)9.
THIS FORM SHOULD NOT BE COMPLETED IF A LEAGUE IS UTILIZING THE JDP QUICKAPP. Visit
LittleLeague.org/localBGcheck for more information.
A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO
COMPLETE THIS APPLICATION.
All RED fields are required.
Name ______________________________________________________________________ Date _________
First Middle Name or Initial Last
Address _______________________________________________________________________________
City _____________________________________ State ___________________ Zip _________________
Social Security # (mandatory) __________________________________________________________
Cell Phone ________________________________ Business Phone ________________________________
Home Phone: ______________________________ E-mail Address:________________________________
Date of Birth ____________________________________________________________________________
Occupation ____________________________________________________________________________
Employer ______________________________________________________________________________
Address _______________________________________________________________________________
Special professional training, skills, hobbies: ____________________________________________________
______________________________________________________________________________________
Community affiliations (Clubs, Service Organizations, etc.):
______________________________________________________________________________________
Previous volunteer experience (including baseball/softball and year):
______________________________________________________________________________________
1. Do you have children in the program? Yes No
If yes, list full name and what level? ______________________________________________________
2. Special Certification (CPR, Medical, etc.)? If yes, list: ______________________________ Yes No
3. Do you have a valid driver’s license? Yes No
Driver’s License#: _________________________________________ State __________________
4. Have you ever been charged with, convicted of, plead no contest, or guilty to any crime(s) involving or against a
minor, or of a sexual nature?
If yes, describe each in full:_____________________________________________ Yes No
(If volunteer answered yes to Question 4, the local league must contact the Little League Security Manager.)
5. Have you ever been convicted of or plead no contest or guilty to any crime(s)? Yes No
If yes, describe each in full: ___________________________________________________________
(Answering yes to Question 5, does not automatically disqualify you as a volunteer.)
6. Do you have any criminal charges pending against you regarding any crime(s)? Yes No
If yes, describe each in full: ___________________________________________________________
(Answering yes to Question 6, does not automatically disqualify you as a volunteer.)
Little League
®
Volunteer Application – 2021
Do not use forms from past years. Use extra paper to complete if additional space is required.
Please list three references, at least one of which has knowledge of your participation as a volunteer in a
youth program:
Name/Phone
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY OF THAT STATE’S
BACKGROUND CHECK. FOR MORE INFORMATION ON STATE LAWS, VISIT OUR WEBSITE: LittleLeague.org/BgStateLaws
AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background check(s) on
me now and as long as I continue to be active with the organization, which may include a review of sex offender registries (some of
which contain name only searches which may result in a report being generated that may or may not be me), child abuse and criminal
history records. I understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my
background. I hereby release and agree to hold harmless from liability the local Little League, Little League Baseball, Incorporated, the
officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand
that, regardless of previous appointments, Little League is not obligated to appoint me to a volunteer position. If appointed, I understand
that, prior to the expiration of my term, I am subject to suspension by the President and removal by the Board of Directors for violation
of Little League policies or principles.
Applicant Signature ____________________________________________________ Date _______________
If Minor/Parent Signature _______________________________________________ Date _______________
Applicant Name (please print or type) __________________________________________________________
NOTE: The local Little League and Little League Baseball, Incorporated will not discriminate against any person on the basis of race,
creed, color, national origin, marital status, gender, sexual orientation or disability.
League Official
Coach
Umpire
Field Maintenance
Manager
Scorekeeper
Concession Stand
Other _____________
7. Have you ever been refused participation in any other youth programs and/or listed on the SafeSport Centralized
Disciplinary Database or USA Baseball Ineligible List? Ye s No
If yes, explain: ____________________________________________________________________
(If volunteer answered yes to Question 7, the local league must contact the Little League Security Manager.)
In which of the following would you like to participate?
(Check one or more.)
LOCAL LEAGUE USE ONLY:
Background check completed by league officer _________________________ on _________________
System(s) used for background check (minimum of one must be checked):
Review the Little League Regulation 1(c)(9) for all background check requirements
*Please be advised that if you use JDP and there is a name match in the few states where only name match searches can be performed
you should notify volunteers that they will receive a letter or email directly from JDP in compliance with the Fair Credit Reporting Act
containing information regarding all the criminal records associated with the name, which may not necessarily be the league volunteer.
Only attach to this application copies of background check reports that reveal convictions of this application.
JDP (Includes review of the SafeSport Centralized Disciplinary and USA Baseball Ineligible List)*
National Criminal Database check
National Sex Offender Registry
SafeSport Centralized Disciplinary Database and/or
USA Baseball Ineligible List Sex Offender
OR
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