2019 CSRVIII Long Course Championship
Answers marked with a * are required.
 
1. First Name: *
 
 
 
2. Last Name: *
 
 
 
3. E-Mail Address: *
 
 
 
4. Wireless Phone #: *
 
 
 
5. LSC: *
 
 
 
6. Background Check and Athlete Protection up to date?
  Yes No
Background Check
Athlete Protection
 
 
 
7. I will work all sessions: *
 
 
 
8. If not all sessions, please indicate what sessions you can work:
 
 
 
9. Please select your current highest certification as an official in each position.
  None LSC N2 N3
AO
S&T
CJ
STR
DR
Ad R
 
 
 
10. What position would you like to be considered for (pick two, prioritization goes to officials working all sessions seeking an N3 evaluation, then N2, then no evaluation)?
  Any AO S&T CJ STR DR AD Ref
1st Choice
2nd Choice
 
 
 
11. If offered, your preferred shirt size (prioritization goes to officials working all sessions).
  S M L XL 2XL 3XL
Men's
Women's
 
 
 
12. Please consider me for a complimentary hotel room. Rooms may be available, dual-occupancy, to share with another official for officials working all sessions, traveling more than 45 miles, and without an athletes staying with them.

      

 
 
 
13. If available, request for an evaluation (select one).
  None N2 N3i N3f N3r Not Sure
AO
S&T
CJ
STR
DR
AR
 
 
 
14. Most recent evaluation, date and evaluator name:
 
 
 
 
 

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