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2020 MDSI Senior Champs Application to Officiate
Thank you for volunteering to officiate at the 2020 MDSI Senior Champs. We need to collect some information from you to allow us to communicate with you and assign you to positions during the meet. A copy of your completed form will be e-mailed to you.

This will be an officials qualifying meet for N2 and N3 evaluations (N2 only for AO & SR). If you would like an N3 evaluation for SR, please indicate below, and we will do our best to find you evaluator. For additional information about the National Officials Certification Program, please visit https://www.usaswimming.org/utility/landing-pages/officials/national-certification-and-evaluation.

If you would like a meet shirt, or would like an evaluation, please submit your application by January 20, 2020. Applications will continue to be accepted after January 20, 2020, but shirts and evaluations cannot be guaranteed.

Feel free to contact the Team Lead Chief Judge, Satoshi Katsumoto, at katsus@gmail.com, with any questions that you may have.

Thanks again for volunteering. We look forward to seeing you on deck.
Email address *
Your Information
First Name *
Your answer
Last Name *
Your answer
Cell Phone *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
LSC *
Your answer
Team *
Your answer
Shirt Size *
Certifications & Evaluation Request
Current Certifications *
LSC
N2
N3
None
AO
ST
CJ
SR
DR
AR
N2 Evaluation(s) Requested *
N2
N2 Recert
None
AO
ST
CJ
SR
DR
AR
N3 Evaluation(s) Requested *
N3
N3 Initial
N3 Final
N3 Recert
None
ST
CJ
SR
DR
AR
Availability
Thursday, February 20, 2020 *
Available
Not Available
Maybe
Timed Finals
Friday, February 21, 2020 *
Available
Not Available
Maybe
Prelims
Finals
Saturday, February 22, 2020 *
Available
Not Available
Maybe
Prelims
Finals
Sunday, February 23, 2020 *
Available
Not Available
Maybe
Prelims
Finals
A copy of your responses will be emailed to the address you provided.
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