10/10/2014 10:04:16 AM USA Swimming, Inc. Non-Athlete Membership Registration USA-S ID Name Address Phone 063050ANNVBALO Balog, Ann Victoria Pref: Vicki 401 N 57th Ave PNY Alert! Gender: Female DOB: 6/30/1950 LSC Pos: PT Coach, Official Pensacola, FL 32506-5338 Trans: Renew (M) (850) 554-0625 Background Check: 2/28/2015 - Level II Reg Typ Family 1 Ethn1: No Response Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/11/2013 Reg Dt. 9/17/2013 CPR: 12/29/2014 [email protected] Club Safety: 12/11/2013 FOC Req: FOC Orig. US Citizen: No FINA: No 093069JOHABOXM Boxmeyer, John A 13077 Country Club Dr CTA (W) (205) 348-3916 Gender: Male LSC Pos: FT Coach DOB: 9/30/1969 Northport, AL 35475-3259 Trans: Renew (M) (205) 246-1583 Background Check: 4/30/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/31/2014 Reg Dt. 10/9/2013 CPR: 8/25/2015 [email protected] Safety: 8/25/2015 FOC Req: FOC Orig. US Citizen: Yes FINA: No 120169JACRBUSS Bussard-Bertucci, Jacqueline Pref: JackieR 9914 Cedar Croft Cir (H) (865) 531-7295 Gender: Female LSC Pos: FT Coach DOB: 12/1/1969 Knoxville, TN 37932-3605 Trans: Renew (M) (865) 207-7297 Background Check: 8/31/2016 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2015 Ethn2: No Response Valid To: 12/12/2015 Reg Dt. 9/27/2014 CPR: 4/13/2016 TNAQ (W) (865) 207-7297 [email protected] Safety: 12/12/2015 FOC Req: FOC Orig. US Citizen: No FINA: No 050757CHRMCORA Coraggio, Christopher M Pref: Chris 1 Saddlebrook Ln Gender: Male LSC Pos: FT Coach DOB: 5/7/1957 Johnson City, TN 37615-4984 Trans: Renew Background Check: 1/31/2015 - Level II BSC (W) (423) 833-5595 Reg Typ Page 1 Individual of 6 (M) (423) 833-5595 10/10/2014 10:04:16 AM USA Swimming, Inc. Non-Athlete Membership Registration USA-S ID Name Background Check: 1/31/2015 - Level II Address Reg Typ Individual Phone Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/31/2014 Reg Dt. 12/19/2013 CPR: 4/25/2015 [email protected] Club Ethn1: White Safety: 4/25/2015 FOC Req: FOC Orig. US Citizen: No FINA: No 080970ROLGDAVI Davis, Roland Gregory Pref: Greg 107 Demouy Ave (H) (251) 442-8065 DOB: 8/9/1970 Mobile, AL 36606-1457 Trans: Renew (M) (251) 442-8065 Background Check: 2/28/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 9/22/2014 Reg Dt. 1/16/2014 CPR: 9/23/2215 Alert! Gender: Male LSC Pos: FT Coach [email protected] CMSA Safety: 9/22/2014 FOC Req: FOC Orig. US Citizen: No FINA: No 120671JEFMDELL Dellinger, Jefferson M Pref: Jeff 4260 Loblolly Ct DOB: 12/6/1971 Auburn, AL 36830-8196 Trans: Renew (M) (334) 707-2380 Background Check: 6/30/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/31/2014 Reg Dt. 12/30/2013 CPR: 9/25/2015 Gender: Male LSC Pos: FT Coach AUB (W) (334) 707-1980 [email protected] Safety: 9/26/2015 FOC Req: FOC Orig. US Citizen: No FINA: No 090578ROBMDELL Dellinger, Robert M Pref: Robby 2408 Crestdale Cir AUB (W) (334) 707-1980 Alert! Gender: Male DOB: 9/5/1978 LSC Pos: PT Coach, Official Background Check: 1/31/2016 - Level II Birmingham, AL 35216-4855 Trans: Renew Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 9/18/2014 Reg Dt. 12/30/2013 CPR: 9/25/2015 [email protected] Safety: 9/18/2014 Page 2 of 6 FOC Req: FOC Orig. 10/10/2014 10:04:16 AM USA Swimming, Inc. Non-Athlete Membership Registration USA-S ID Name Address Phone FOC Req: FOC Orig. Club US Citizen: No FINA: No 020375BRIEHADD Haddad, Brian E 1500 Black Diamond Dr Apt 1503 Gender: Male LSC Pos: FT Coach DOB: 2/3/1975 Panama City Beach, FL 32407-0273 Trans: Renew (M) (615) 293-7333 Background Check: 3/31/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/31/2014 Reg Dt. 12/11/2013 CPR: 8/14/2016 [email protected] (H) (615) 293-7333 PCST Safety: 8/23/2016 FOC Req: FOC Orig. US Citizen: Yes FINA: No 042853CLARHAMM Hammond, Clark R 2729 Old Trce (H) (205) 967-9727 Gender: Male DOB: 4/28/1953 Mountain Brk, AL 35243-2029 (F) (205) 874-3240 LSC Pos: Official Trans: (M) (205) 910-5390 Background Check: 9/30/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/31/2014 Reg Dt. 12/30/2013 UN (W) (205) 874-0331 Renew [email protected] FOC Req: US Citizen: No FINA: No 011752TOMFHEAL Alert! Gender: Male Healey, Tom F 327 E Longleaf Dr UN (W) (877) 973-7946 DOB: 1/17/1952 Auburn, AL 36832-6234 (F) (334) 887-7955 LSC Pos: PT Coach, Other Trans: (M) (334) 750-1889 Background Check: 5/31/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 9/25/2014 Reg Dt. 12/22/2013 CPR: 9/25/2014 Renew [email protected] Safety: 9/25/2014 FOC Req: FOC Orig. US Citizen: Yes FINA: No Page 3 of 6 10/10/2014 10:04:16 AM USA Swimming, Inc. Non-Athlete Membership Registration USA-S ID Name Address 082579ROBMHELL Heller, Robin M 5425 Hibiscus Rd Alert! Gender: Female LSC Pos: FT Coach Phone Club SAST (W) (850) 418-0645 DOB: 8/25/1979 Pensacola, FL 32504-4731 Trans: Renew (M) (850) 418-0645 Background Check: 3/31/2015 - Level II Reg Typ Family 1 Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 5/28/2014 Reg Dt. 10/21/2013 CPR: 3/8/2016 [email protected] Safety: 5/28/2014 FOC Req: FOC Orig. US Citizen: Yes FINA: No 070669ROBBKALE Kale, Robert B Pref: Brad 125 Tranquility Ln (H) (850) 461-7012 Alert! Gender: Male DOB: 7/6/1969 LSC Pos: FT Coach Background Check: 7/31/2015 - Level II Destin, FL 32541-4776 Trans: Renew Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 5/28/2014 Reg Dt. 12/30/2013 CPR: 5/28/2014 [email protected] CA Safety: 5/28/2014 FOC Req: FOC Orig. US Citizen: No FINA: No 110960WILJMORS Morse, William John Pref: John 6535 Hidden Hollow Trl DOB: 11/9/1960 Brentwood, TN 37027-6315 Trans: Renew (M) (615) 496-5888 Background Check: 3/31/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2015 Ethn2: No Response Valid To: 3/31/2015 Reg Dt. 9/22/2014 CPR: 9/29/2015 Gender: Male LSC Pos: FT Coach NAC (W) (615) 321-3510 [email protected] Safety: 7/12/2016 FOC Req: FOC Orig. US Citizen: No FINA: No 022286ZACRMURR Murray, Zachary Reed Pref: Zach 2019 Stokes Ln (H) (336) 402-4337 Gender: Male LSC Pos: FT Coach DOB: 2/22/1986 Nashville, TN 37215-1519 Trans: Renew (M) (336) 402-4337 Background Check: 3/31/2015 - Level II Reg Typ Page 4 Individual of 6 NAC 10/10/2014 10:04:16 AM USA Swimming, Inc. Non-Athlete Membership Registration USA-S ID Name Background Check: 3/31/2015 - Level II Address Reg Typ Individual Phone Ath. Protection: 12/31/2015 Reg Yr. 2015 Ethn2: No Response Valid To: 3/31/2015 Reg Dt. 9/22/2014 CPR: 8/23/2015 [email protected] Club Ethn1: White Safety: 8/22/2015 FOC Req: FOC Orig. US Citizen: Yes FINA: No 090262SCOTROBI Robinson, Scott T 4325 Tutwiler Ave (H) (901) 791-2689 GST (W) (901) 757-7390 Gender: Male DOB: 9/2/1962 Memphis, TN 38122-2640 (F) (901) 371-0377 LSC Pos: FT Coach Trans: (M) (901) 674-0377 Background Check: 6/30/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/17/2014 Reg Dt. 12/3/2013 CPR: 11/29/2015 Renew [email protected] Safety: 12/17/2014 FOC Req: FOC Orig. US Citizen: No FINA: No 071279MATCWEBB Webber, Matthew C Pref: Matt PO Box 1102 HSA Gender: Male LSC Pos: FT Coach DOB: 7/12/1979 Huntsville, AL 35807-0102 Trans: Renew (M) (205) 482-2776 Background Check: 2/28/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2015 Ethn2: No Response Valid To: 2/28/2015 Reg Dt. 9/1/2014 CPR: 6/10/2015 (W) (256) 270-9255 [email protected] Safety: 6/11/2015 FOC Req: FOC Orig. US Citizen: Yes FINA: No 030466DONSWILL Williamson, Donna S 1760 Russet Hill Cir BSL (W) (205) 934-4752 Gender: Female LSC Pos: Official DOB: 3/4/1966 Hoover, AL 35244-8205 Trans: Renew (M) (205) 266-5585 Background Check: 10/31/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 12/31/2014 Reg Dt. 11/25/2013 [email protected] Page 5 of 6 10/10/2014 10:04:16 AM USA Swimming, Inc. Non-Athlete Membership Registration USA-S ID Name Address Phone Club FOC Req: US Citizen: Yes FINA: No 062973CHRBWRIG Wrighton, Christopher B Pref: Brian 1025 Montgomery Hwy Ste 106 (W) (205) 823-5512 DOB: 6/29/1973 Vestavia, AL 35216-2856 Trans: Renew (M) (205) 823-5512 Background Check: 1/31/2015 - Level II Reg Typ Individual Ethn1: White Ath. Protection: 12/31/2015 Reg Yr. 2014 Ethn2: No Response Valid To: 9/11/2014 Reg Dt. 9/24/2013 CPR: 9/17/2015 Alert! Gender: Male LSC Pos: FT Coach [email protected] BSL Safety: 9/11/2014 FOC Req: FOC Orig. US Citizen: Yes FINA: No Total Count For Report: 18 Page 6 of 6
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