Application to Officiate

Name:     Club:     LSC:

E-Mail:     Phone No:
(your email address is needed so you can be contacted about the meet, your phone no. is optional)

Current Certifications and Level (check all that apply):

Referee N1--PVS N2--Nat'l N3--Nat'l Champ    Starter N1--PVS N2--Nat'l N3--Nat'l Champ    Stroke&Turn N1--PVS N2--Nat'l N3--Nat'l Champ   
Hy-Tek     Colorado

Sessions (check all that apply):

Comments (include specific assignment requests here):
   

You must apply no later than July 17th 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.