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Fill in form and print out and mail to Jupiter/Tequesta Athletic Association, P.O. Box 3024, Tequesta, Florida 33469
Name: Address:
Address: City:
Zip: Home Phone:
Bus. Phone: E-Mail:
Occupation: Employer:
Manager* Coach* Assistant Coach League Director Team Parent Computer Work
Concession Umpire** Field Field Maintenance Other Clerical Administrative
*NOTE: JTAA requires that all managers and coaches maintain NYSCA certification.
Are you NYSCA certified? Date of last NYSCA class?
Do you have children in JTAA-Baseball Program? What ages?
If applying for a position as a manager or coach, please indicate previous experience, level of play, League and Year:
Special certifications, skills or professional training:
Have you ever been refused participation in any programs?
If yes, please submit an explanation in a sealed envelope attached to this application.
Have you previously served in the JTAA-Baseball program?
If you have not previously served JTAA-Baseball, please provide the names and phone number of three personal references on the reverse side of this application.
I understand that my appointment to any position within the JTAA-Baseball Program is entirely contingent upon the consideration and approval of the JTAA-Baseball Board and the JTAA Executive Board. I agree to abide by the By-Laws and Rules of JTAA-Baseball and the JTAA. I understand that my appointment is also contingent upon obtaining and maintaining NYSCA certification and attendance at certain classes, meetings and clinics (such as PAYS, rules, umpire and/or skills) as the JTAA-Baseball Board and/or the JTAA Executive Board may require.
Signed: Date:
 
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