2017 PVS LC Senior Championships
Application to Officiate and Request for Evaluation

July 6-9, 2017, Freedom Aquatic & Fitness Center, Manassas, VA

This is a National Officials Qualifying Meet (OQM). If you are interested in officiating during the meet, please fill out the form below and submit. This form will also record your request to be evaluated for N2 or N3 status in USA Swimming. Requests for evaluation must be submitted by 6/25/17 in order to be honored. Anyone requesting an N2 or N3 evaluation must be willing to officiate for a minimum of 4 sessions during the meet.

All requirements for advancement and recertification can be found on the USA Swimming site on the Officials resource page at www.usaswimming.org/DesktopDefault.aspx?TabId=1515&Alias=Rainbow&Lang=en-US

If you are not requesting an evaluation, please note that in the Evaluation Request drop down menu.

If you have any questions about the N2/N3 certification process or the meet itself, please contact the Meet Referee, Pam Starke-Reed at pesreed@yahoo.com or the PVS Officials Chair, Tim Husson at thusson@comcast.net.

We thank you for your interest in officiating this meet and look forward to seeing you at the 2017 Potomac Valley Long Course Senior Championships.

See you on the deck soon!

Email address
Officials Information
Name
(Last, First)
Your answer
LSC
Shirt Size
This is not a guarantee that shirts will be provided. It is anticipated that shirts will be provided to officials that work a total of at least four sessions at LC Senior Champs, LC Junior Champs, and LC Age Group Champs
Certifications and Evaluation Request
Certifications
List highest certification level at each position
None
LSC
N2
N3
S&T
Starter
Chief Judge
Deck Referee
Administrative Referee/Administrative Official
Timing System Operator
Computer Operator
Request for Evaluation
Please indicate your desire for N2/N3 evaluation
Requested Level for Evaluation
Required if you requested evaluation above
Requested Position for Evaluation
Required if you requested evaluation above
I would like to be assigned to the following position for the meet
Required
Session Availability
Thursday Preliminaries
Thursday Finals
Friday Preliminaries
Friday Finals
Saturday Preliminaries
Saturday Finals
Sunday Preliminaries
Sunday Finals
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms