Application to Officiate

Potomac Valley Junior Olympic Championships
PGS&LC, Landover, MD
March 19-22, 2009

You may use this form to apply to officiate the Potomac Valley Junior Olympic Championship meet. You may also email your request to the Meet Officials Coordinator.

We have applied to have this meet designated as a "qualifying meet" under the national officials' certification program. Any official interested in being evaluated (N2 only - all positions) must apply in advance. Send the "Request for Evaluation" form (PDF or DOC) to the PVS Officials Chair. Also indicate your evaluation request on the form below. Details of the certification program can be found on the Certification Page of the USA Swimming website.

Name:     Club:     LSC:

E-Mail:     Phone No:

Current Certifications and Level (check all that apply):

   Referee    Starter    Stroke&Turn   

    Hy-Tek     Colorado

Sessions I will work (check all that apply):

Thursday Distance
Friday Prelims Friday 10&U Prelims Friday Finals
Saturday Prelims Saturday 10&U Prelims Saturday Finals
Sunday Prelims Sunday 10&U Prelims Sunday Finals

Course Preference for Preliminaries:

Girls Course Boys Course No Preference

I request to be evaluated at:      

Comments (include specific assignment requests here):
   

You must apply no later than March 12th for specific deck positions. However, late applications to officiate at this meet and walk-ins are also welcome and will be assigned to available positions.