PATIENT INFORMATION BOOKLET - Bausch + Lomb

MEN'S AND WOMEN'S BASKETBALL

ONLINE BACKGROUND CHECK PROGRAM PROCEDURES

Access the Web site at this address:

https://web1.ncaa.org/choOfficials/exec/login

NCAA DIVISION I GAME OFFICIALS BACKGROUND CHECK PROGRAM

Welcome to the NCAA Game Officials Background Check System.

Each year, many men and women serve as officials for NCAA Division I championships and postseason

football bowl games. These championships are the Association's most high-profile events, so the

character of the officials is important. The NCAA takes very seriously it's obligation to do everything necessary to prevent gambling scandals from occurring.

For a game official to be eligible for selection to officiate an NCAA championship in the sports of baseball, men's basketball, men's ice hockey or women's basketball; or to officiate a postseason

football bowl game, the official must complete the online background check form each year. A random selection then determines which officials undergo an actual check.

The Division I men's and women's basketball officials have undergone background checks since 1999. As part of the recommendations from the NCAA Sports Wagering Task Force, beginning with the 2005-06 season, baseball and men's ice hockey officials are required to undergo background checks. The NCAA Division I Football Issues Committee recommended that background checks be required for officials working postseason football bowl games beginning in 2006.

Questions regarding the background check program can be addressed by contacting Suzanne Brickell at [email protected].

Questions regarding clinic attendance and online test scores can be addressed by contacting the following individuals:

Football and Baseball

Kim Giles [email protected]

Men's Basketball Jay Jay Rackley [email protected]

Women's Basketball

Rachel Kay [email protected]

Enter Log-in information

Last Name

Last 4 digits of Social Security Number

Submit

© 2007 NCAA

https://web1.ncaa.org/choOfficials/exec/login

mailto:[email protected]



Men's and Women's Basketball

Online Background Check Procedures

Page No. 2

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1. Read the introduction page, enter your last name and last 4 digits of your social security number

and click submit.

NOTE: You must be entered in the championships officials database before you can access the

game officials background check program. Many officials are already in the database from

previous years. New officials will be entered as they attend officiating clinics. Please allow one

week after clinic attendance for your information to be entered into the database.

2. This page reflects the dates when the system will be available for officials to enter the required

background check information.

3. The left side of the screen will reflect the most recent regional officiating clinic attendance, most

recent background check forms on file, most recent sports wagering questionnaire on file and the

most recent online rules test on file.



Page No. 3

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4. Officials will be responsible for updating their personal information throughout the year. If your

address, phone number or your conference affiliations change, it is your responsibility to go into

this system and make those changes. If you make changes anytime during the year, you must click

the "save" button at the bottom of the screen.

5. Select the sport code for the sport that you officiate. If you officiate more than one sport, you must

complete the entire process for each sport (i.e. men's basketball, women's basketball, men's ice

hockey, baseball or postseason football).



Page No. 4

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6. Personal Information:

Enter you complete address, city, state and zip code.

E-mail address is optional, but we encourage you to provide that information.

Enter telephone numbers for home, work and cell.

Drivers license number is required.

The state in which your drivers license is issued is required.

Birth date is required.

Personal information:

Address: 700 W. Washington

City: IndianapolisState:

INZip code:

46206

E-mail: [email protected]

Home Phone: 317-917-6866(No spaces, dashes, etc.)

Work Phone: 317-917-6222(No spaces, dashes, etc.)

Cell Phone: 317-917-3333

Driver License Number: 753951456

State Issued: IN

Birth Date: 02/28/1955(mm/dd/yyyy)



Page No. 5

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7. United States Citizenship (New this year).

You must indicate if you are a US citizen. If you are not a US citizen, you must send to the agent,

gambling and amateurism activities staff verification that you are legally residing within the United

States and are able to earn income as an independent contractor. This information will be verified

before an official is eligible for selection.

Note: If you are not a United States citizen, you are required to provide documentation that you are legally residing within the United States and are able to earn income as an independent contractor. This information will be verified. You must send a copy of your documentation to Rachel Newman Baker, Director of Agent, Gambling and Amateurism Activities, P.O. Box 6222, Indianapolis, Indiana 46206. In the area below, please enter the type of documentation you have that allows you to work as an independent contractor in the United States (i.e. Green Card, visa type, etc.).

US Citizen: Yes No

8. Gender and Ethnicity information is optional.

Note: Gender and Ethnicity information is optional

Gender: Male Female

Ethnicity:



Page No. 6

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9. Conference affiliation - check all that apply.

Conference affiliation (please check all that apply):

AMERICA EAST CONFERENCE

ATLANTIC 10 CONFERENCE

ATLANTIC COAST CONFERENCE

ATLANTIC SUN CONFERENCE

BIG 12 CONFERENCE

BIG EAST CONFERENCE

BIG SKY CONFERENCE

BIG SOUTH CONFERENCE

BIG TEN CONFERENCE

BIG WEST CONFERENCE

COLONIAL ATHLETIC ASSOCIA

CONFERENCE USA

HORIZON LEAGUE

INDEPENDENT

IVY GROUP

METRO ATLANTIC ATHLETIC C

MID-AMERICAN CONFERENCE

MID-EASTERN ATHLETIC CONF

MISSOURI VALLEY CONFERENC

MOUNTAIN WEST

NORTHEAST CONFERENCE

OHIO VALLEY CONFERENCE

PACIFIC-10 CONFERENCE

PATRIOT LEAGUE, THE

SOUTHEASTERN CONFERENCE

SOUTHERN CONFERENCE

SOUTHLAND CONFERENCE

SOUTHWESTERN ATHLETIC CON

SUMMIT

SUN BELT

WEST COAST CONFERENCE

WESTERN ATHLETIC CONFEREN

10. Click "Go" to proceed to the next step.



Page No. 7

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11. General Policies. You must read this page and check the box at the bottom that you agree to the

terms and conditions that are specified in the general policies.

12. At the bottom of the General Policies page are links to other documents that are helpful in

understanding the NCAA Game Officials Background Check Program.



Page No. 8

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13. NCAA Position on Sports Wagering. This document appears as a word document; close the

document to return to General Policies page.

14. Frequently Asked Questions. Helpful questions and answers about the NCAA Game Officials

Background Check Program. This document appears as a word document; close the document to

return to the General Policies page.



Page No. 9

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15. Click Background Check Form to begin completing the necessary documentation.

16. Authorization and Release of Custodial Information. You must read and check the box that you

have read the release, understand it and agree to the terms and conditions therein.



Page No. 10

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17. The information that appears on your log-in page (name, address, etc.) will automatically appear on

the bottom portion of this page. Click Personal Background Questionnaire.



Page No. 11

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18. Other names. List any other names you may be known by, including maiden name, and dates

names were used.

19. Address. List all address where you have resided during the past seven years. The dates that you

lived at each address are also required.



Page No. 12

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20. Employer Information. Enter employer name, department in which you work, phone number,

address, city, state and zip. You must also provide an explanation of your duties.

21. If you are self-employed or hold 10 percent ownership or more of the business that employs you,

you must provide an explanation.

22. If you have ever been convicted of a violation of law, or have been charged with a crime that is

awaiting adjudication, you must provide an explanation.

23. If you have claimed bankruptcy, or been the subject of a collection account, or the subject of a lien,

suit or judgment, you must provide an explanation.



Page No. 13

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24. Click "sports wagering questionnaire" to proceed to next portion.

25. Answer each question with "yes" or "no." A "yes" answer requires an explanation. After

completing the questionnaire click submit.



Page No. 14

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NOTE: By clicking submit, you are certifying that all of the information furnished on the questionnaire is

true, complete and correct. After you click submit, you will not be able to access the forms again. So be

sure your answers are accurate before submitting.

26. After submitting, print a copy of your forms for your records. Your printed copy will reflect the

date that you submitted your forms.



Page No. 15

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27. If you go back into the system after you have submitted the information, you will receive a message

that your background check questionnaire was already submitted. You can print a copy, but will

not be able to access the information.

NCAA DIVISION I GAME OFFICIALS

BACKGROUND CHECK PROGRAM

Background check questionnaire was already submitted on August 30,

2007.

The National Collegiate Athletic Association

September 4, 2007 esb

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