APPLICATION TO OFFICIATE

2014 WESTERN ZONE SENIOR CHAMPIONSHIPS
Clovis North & Clovis West Aquatics Complexes
Fresno, California
July 30 – August 3, 2014

Applicant must be a current member of USA Swimming and an LSC certified official

Name: ______LSC Code: ______

Address: ______Home Phone: ______

City, State, Zip: ______Work Phone: ______

E-mail: ______Cell Phone: ______

CURRENT CERTIFICATIONS - List Highest Only

N1: ______Exp Date: ______

N2: ______Exp Date: ______
_
N3: ______Exp Date: ______

Accepted applicants must attend mandatory official’s briefings as specified in the acceptance letter.

You must be certified at the position(s) for which you apply. Applications for the assigned positions (Chief Judge, Starter and Deck Referee) must be received by June 22, 2014. All other applications must be received by July 6, 2014. Acceptances for assigned positions will be sent on or about July 1st; all others will be sent on or about July 15th. We will try to accommodate all Requests for Evaluation, which must be received by July 6, 2014 for consideration.

Requested Assignment: ______

(Stroke & Turn, Chief Judge, Starter, Deck Referee or as needed)

PLEASE CHECK THE SESSIONS AT WHICH YOU WILL BE AVAILABLE TO VOLUNTEER

I will serve at all sessions I can only serve at the following sessions -

Wednesday July 30 Finals

Thursday July 31 Prelims Finals

Friday August 1 Prelims Finals

Saturday August 2 Prelims Finals

Sunday August 3 Prelims Finals

DRESS FOR THIS MEET

Preliminaries – White polo shirt, khaki pants (short or long) or skirts/skorts (short or long), white shoes and white socks.

Finals – White polo shirt, khaki pants or skirts, white shoes and white socks.

Shirt size: (please check one) S M L XL 2XL 3XL (This is for Host planning and is not guaranteed.)

Please Return Application by mail or e-mail to: Don Hougardy

Please call or e-mail with questions. The 2014 Western Zone Officials’ Chair

Western Zone Leadership Team (Mary Jo Swalley - 840 SE Bishop Blvd, Ste #202

Meet Referee, Gloria Schuldt – Administrative Pullman, Washington 99163

Referee and Don Hougardy – WZ Officials’ Chair) thank you in (509) 334-4700 (work)

advance for volunteering your time. We are looking (509) 432-6431 (mobile)

forward to seeing you in California.