Board & Executive Education Program
The First Tee Recognized Executive
Prerequisite Completion Form
Contact Information
First Name:
Last Name:
Present Chapter & Region:
Email: Contact Phone Number: ()
Employment Information
Title at The First Tee Chapter
Revised 7/2/2013
Executive Director
Program Director
Board Member
The First Tee Coach
Revised 7/2/2013
If Other, please explain:
Status
Full Time
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Part Time
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Start date with current The First Tee Chapter/
Month Year
Name of Former The First Tee Chapter:
Number of years serving at the former Chapter:
Demographics
Ethnicity
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African-American
Asian-American
Caucasian
Hispanic
Multi-Racial
Native-American
Pacific Islander
Other
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Gender
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Male Female
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Birth date: / /
Month Day Year
Education
Undergraduate School:
Year of Graduation: Undergraduate Degree:
Graduate School Name:
Year of Graduation: Graduate Degree:
Credentials/Certifications:
Board & Executive Education Program
The First Tee Recognized Executive
Prerequisite Completion Form
Page 2
Golf
Years Playing Golf: Golf/USGA Handicap:
LPGA Member? PGA Member?
Revised 7/2/2013
Community Involvement
Organizations/Clubs/Civic Awards Received:
Prior Occupations
Please list prior occupations and number of years in each:
Prerequisitedocumentation to accompany application
Revised 7/2/2013
Position / job description
Participant Par CertificationTests in golf knowledge and life skillsknowledge
Trip report from a Chapter visit
Revised 7/2/2013
Prerequisite Signatures
Executive
I, from The First Tee of
certify that I have reviewed the The First Tee Executive requirements and am striving to become a The First Tee Recognized Executive. I have read and am familiar with The First Tee Coach philosophy and the Life Skills Experience materials. I have reviewed and am familiar with myChapter’s Articles of Incorporation, bylaws, business plan, current financial statements and budgets, and recent board minutes. I have reviewed the ZONE Manual with my director of regional affairsand am familiar with the program. I understand that connecting with the Network of The First Tee Chapters is an effective way to acquire new ideas about existing successful practices; therefore, I visited The First Tee of ______on ______/20 ____. All of the attached information is correct, and I will continue to review and update all information as I move through the The First Tee Recognized Executive process.
SignatureMonth/Day/Year
The First Tee Chapter Board President Signature
As the current Board President of The First Tee of ____, I certify that I have reviewed The First Tee Executive requirements with ______. The applicant’s involvement at my Chapter is at a management level which involves duties beyond coaching or educational assistance. Their responsibility includes building and sustaining our local nonprofit business. I have reviewed the job description included with this completion form. I will continue to assist and review all information as throughout the recognition process.
SignatureMonth/Day/Year
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