Application to Officiate

Potomac Valley Junior Olympic Championships
Fairland Aquatics Center, Laurel, MD
March 18-21, 2010

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 Meet Referee. 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
Fri 13-14 Prelims Fri 11-12 Prelims Fri 10&U Prelims Fri Finals
Sat 13-14 Prelims Sat 11-12 Prelims Sat 10&U Prelims Sat Finals
Sun 13-14 Prelims Sun 11-12 Prelims Sun 10&U Prelims Sun 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 11th 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.