2017 MSI 14 & U Championships: Application to Officiate
Please submit form by February 1, 2017 if you would like to receive a meet shirt or an assigned position on deck. It is preferred THREE or more sessions be worked to receive an assigned position. FOUR sessions MUST BE WORKED for either an N2/N3 evaluation. Applications will be accepted after Feb 1 until March 1. A shirt IS NOT GUARANTEED after Feb 1.
Order Due by February 1, 2017 *
Men's and Women's styles are available with preferred sizes. The shirts tend to run small. Consider ordering one size larger. Please select a size below.
Official Information
Last Name *
Your answer
First Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
E-Mail Address *
Your answer
Phone Number *
Your answer
Emergency Contact Number *
Contact phone number in case of emergency during meet
Your answer
Certification *
Please indicate the highest certified position from the drop down list below. If you would like to request an assigned position but aren't requesting an evaluation, please contact the meet referee. Priority consideration for assigned positions will be given to those requesting evaluations. No LSC apprentice evaluations will be offered at this meet.
Certification Level *
Please indicate the highest Level of certified position from the drop down list below
Request for Evaluation
This is an Officials Qualifying Meet (OQM). If you wish to be evaluated at a N2 positions please indicate below. Please be advised that in order to be evaluated at an OQM you must work at least FOUR (4) sessions as an official at the meet. Sessions in excess of those required for evaluation need not be worked in the evaluated position. Priority for assigned positions will be given to those requesting evaluations. No LSC apprentice evaluations will be offered at this meet.

If no evaluation is requested, please mark the first box.

Please Indicate Position for Which You Wish to be Evaluated *
Level of the Evaluation Requested *
Session Availability
Please indicate your availability from the sessions below
March 2, 2017 *
Yes
No
Maybe
Timed Finals
March 3, 2017 *
Yes
No
Maybe
Prelims
Finals/Time Finals
March 4, 2017 *
Yes
No
Maybe
Prelims
Finals/Timed Finals
March 5, 2017 *
Yes
No
Maybe
Prelims
Finals/Timed Finals
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