Application to Officiate

Application to Officiate
Potomac Valley Long Course Age Group Championships
Fairland Aquatics Center
July 22-25, 2010

You may use this form to apply to officiate the Potomac Valley Long Course Age Group Championship meet. You may also email your request to the Meet Referee.

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    Starter    Stroke&Turn   
Hy-Tek     Colorado

Sessions (check all that apply):

Thursday 11&O Prelims Thursday 10&U Prelims Thursday Finals
Friday 11&O Prelims Friday 10&U Prelims Friday Finals
Saturday Afternoon
Sunday 11&O Prelims Sunday 10&U Prelims Sunday Finals

Comments (include specific assignment requests here):

You must apply no later than July 13th 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.