National Junior Basketball Chapter Director Application

Please fill out completely.  Do not leave anything blank.  If it does not apply to you, please enter or select N/A.

Thank you,
NJB Administration


Directions:
Fill out completely, and click "Send Form"

 


 
Chapter Director Application

Start your Application:

First Name:

Last Name:

Address:

City:
State:
Zipcode:

Chapter:

Home Phone:

  (Example:  000-000-0000)

Work Phone:

  (Example:  000-000-0000)

 Cell Phone:

  (Example:  000-000-0000)

Contact Phone:

  (Example:  000-000-0000)
*Chapter contact phone number will be the number provided to the public by NJB headquarters.*
 

 Email:

(1) Do you have a child registered in the league?
 Yes No
 
 (2) Have you been NJB Live Scanned/Fingerprinted?
Yes No
 
(3) Have you ever been accused or convicted of a felony?
 Yes No
 
(4) Have you ever been registered for any offense under 290 C.P.C. sexual offender registration (or equivalent penal code in your state)?
Yes No
 
(5) Have you ever been involved with any other youth program?
 Yes No

If you answer Yes to question (5). Please provide the program names, contact information and describe your duties/responsibilities:
 
(6) Have you ever had any complaints against you regarding your behavior?
 Yes No
 
 

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