Affiliation Information Form

This simple form will allow us to craft a presentation that suits your needs, and those of your community. Just fill it out, hit "submit" and we'll get the ball rolling!

As always, if you'd like to speak with someone directly, call Little League International at 570-326-1921, and ask for Dan Velte at extension 223.

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1. Your Name 2. Street Address 3. City 4. State or Province 5. Zip Code 6. Country 7. Evening phone number (w/area code) 8. Daytime phone number (w/area code) 9. Email address  Enter a valid email address. Example: name@company.com 10. Your title or position in the local baseball/softball organization 11. Your local baseball/softball organization name 12. Is your existing baseball/softball organization affiliated with any national or regional organizatoin? Yes No 13. If you answered "yes" to No. 12, please briefly explain why you may no longer wish to affiliate with that organization. 14. Indicate below which of these applies to your current organization: Baseball only Softball only Baseball and Softball 15. Please list the age ranges of players in your current organization (example, "8 through 15"): 16. How many teams are in your current program? 17. How did you hear about Little League? (please check all that apply) Television commercial World Series broadcast Magazine Newspaper Internet Friend or relative Facebook Other (please explain below) 18. If you answered "Other" to No. 17, please explain. 19. Please indicate the level of interest you have in bringing Little League to your community: Extremely interested Very interested Somewhat interested Just curious 20. What is your opinion of the chance that your community might affiliate with Little League for the next regular season? Excellent chance Good chance Poor chance 21. The items below are available ONLY to chartered Little League programs. Please number the top five aspects about chartering with Little League that your league and community might find most important in your decision (with "1" being the most important).   Charter fee ($16 per team, per year) Enter a valid ranking. Example: 1, 2 or 3   Accident insurance fee (ranges from $18 to $48, per team per year) Enter a valid ranking. Example: 1, 2 or 3   Liability insurance fee (annually ranges from $101 per league to $30.30 per team for leagues with more than 14 teams) Enter a valid ranking. Example: 1, 2 or 3   The possibility of making it to the World Series in Williamsport, or any of the seven other World Series tournaments in baseball and softball Enter a valid ranking. Example: 1, 2 or 3   No extra fee for Little League tournaments beyond district, AND reimbursement of $1 per mile (one round trip) for leagues with teams advancing beyond district Enter a valid ranking. Example: 1, 2 or 3   One free Little League rule book for each team chartered Enter a valid ranking. Example: 1, 2 or 3   Free materials for establishing constitution, by-laws, committees, etc. Enter a valid ranking. Example: 1, 2 or 3   Full-time rules interpretation service by telephone and email Enter a valid ranking. Example: 1, 2 or 3   Little League Umpire Registry Enter a valid ranking. Example: 1, 2 or 3   Training at Regional Centers for league officers, managers/coaches, and umpires Enter a valid ranking. Example: 1, 2 or 3   Democractic voice by local Little Leagues in rule changes Enter a valid ranking. Example: 1, 2 or 3   Boundary protection ("raiding" by other Little Leagues prohibited) Enter a valid ranking. Example: 1, 2 or 3   A Safety Awareness Program (ASAP) Enter a valid ranking. Example: 1, 2 or 3   Little League Manager/Coach Education Program Enter a valid ranking. Example: 1, 2 or 3   Click here to edit text. Enter a valid ranking. Example: 1, 2 or 3 22. Do you think your community's decision to possible affiliate with Little League might be more likely if a Staff Member from Little League International or someone from a Regional Headquarters visits your area for a presentation? Yes No 23. If you know the name of the Little League District Administrator in your area, please list it here: 24. Has a Little League District Administrator visited/telephoned you or a member of your organization recently? Yes No 25. If you know the name of the nearest chartered Little League program to your location, please list the name of the league and the city/town and state/province here: 26. Do you have any other questions or comments?