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* 1. Name

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* 2. Cell Phone & E-mail

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* 3. Date of Birth

Date

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* 4. Football or Cheer? Position? Level?

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* 6. Coaching Experience

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* 7. Have you ever been arrested of convicted of a felony? explain?

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* 8. Have you been convicted of a misdemeanor involving violence in the last 10 years?  Explain

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