Connecticut State Referee Program
11 Executive Drive
Farmington, CT 06032
860-676-1161
860-676-1162 fax

To: Tournament Directors

From: State Referee Administrator

Subject: Referee Lists and Referee mailing Labels

Upon request, the CSRP will provide Sanctioned Tournaments with mailing labels and a corresponding list of certified Referees. Only USSF certified Referees can officiate at sanctioned tournaments. Referees are certified annually for a calendar year and the Referee’s badge and registration card must be valid for the current year. Out of state Referees and some first year Referees will not be on certain lists.

The Referee list and labels are of a confidential and restricted nature. They are intended for the use only by the Tournament (Referee Assignor/Coordinator) for notification and verification of Referee participation.

Name of Sanctioned tournament / Signature of Club President

Please indicate below if there are any specific age or District/Area requirements:

CE / X / NC / X / NE / X / NW / X / SC / X / SE / X / SW / X
Ages: / All / X / Older than / Grade / 988 and higherAll

Labels are to be used for mailings to invite Referees to officiate in your tournament. Lists are to be used to verify that a Referee is currently certified by USSF. The labels and lists will not to be reproduced and information on them is not to be distributed to anyone for any other purpose.

One Referee list and two sets of mailing labels will be supplied at a cost of $100.00 payable to “CSRP”.

Please sign, date and return this request with your check to the address shown above and a list and lable package will be sent to you. By requesting and receiving this list, you agree to the all conditions stipulated by the CSRP.

Contact Information:

Name
Address
City, State, Zip Code
Phone Numbers / #1 / #2
Signed /

Date

/ /