Application to Officiate at 2018 LC STAGS at Palo Alto College San Antonio, July 12 - July 15 2018
This form will be used to apply to help officiate at the meet and to request for Evaluation for National Upgrades of your USA Swimming Certification.

If you are interested in officiating during the meet, please fill out the form below and submit. Requests for assigned positions should be submitted by May 8, 2018 to ensure consideration.

This is an Officials National Qualifying meet (OQM).This form will also record your optional request to be evaluated for N2 or N3 status in USA Swimming's National Certification Program. Anyone requesting N2 or N3 must be willing to officiate at the meet for a minimum of 4 sessions and must meet USA Swimming's requirements for evaluation as found on the USA Swimming site on the Officials resource page at . Requests for evaluations in assigned positions should be submitted by May 8. Requests for S&T evaluations should be submitted by June 29.

If you have any questions about officiating at the meet or about the N2/N3 certification process, please contact the Meet Referee, Ray Pearce at .

Name: *
Your answer
Address: *
Your answer
Email: *
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Cell Phone # *
Your answer
Highest Qualification in your LSC *
Your answer
Highest Certification in USA Swimming *
Your answer
Please indicate the position or positions you are willing to work *
Will you be working all Sessions *
If the above is "No" or "Maybe" please select the Sessions you will be working
If you are willing to help with Time Trials please select the Sessions you will be working
Please mark the position and the National Level you would like to Evaluated for. (see Evaluations that will be available at this meet) S&T N2 & N3; Chief Judge N2, N3i, & N3R; Starter N2; Deck Ref N2
Chief Judge
Deck Referee
Remember you need to work 4 Session in the position you are wanting to be evaluated for. Time Trials can not be counted.
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Shirt Size *
Any special Notes or Concerns please let me know : __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Thank You for helping with the 2018 STAGS Meet Ray Pearce Meet Referee
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