Premier Football Officials Application Form

MID-EASTERN ATHLETIC CONFERENCE FOOTBALL OFFICIATING APPLICATION
A: Personal Information
Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Celll Number*
Other
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Age*
Weight*
Height*
Occupation:*
College(s) Attended: *
B: Football Officiating Experience
Number of years you have officiated:
High School
College
Other
Level at which you have officiated football:
Div I
Div II
Div III
Current College Conference:
Indicate your position preference:
Position Preference 1*
Position Preference 2
Position Preference 3
C: Officiating References:
List the names, email addresses and phone numbers of three qualified individuals who have observed your work as a football official. These individuals may be contacted.
Reference 1 Name Email address Telephone #*
Reference 2 Name Email address Telephone #*
Reference 3 Name Email address Telephone #*
D: Officiating Schedule
Please upload your entire football officiating schedule from previous seasons. This should include the date, position worked and the teams involved.
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E: Professional and Officiating Resume:
Please provide an updated professional occupational resume along with your complete officiating resume. Include a current color photo (full body) in your officiating uniform and a separate head shot.
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F: Criminal and Financial Background History:
YesNo
If yes, provide details:
YesNo
If yes, provide details:
YesNo
If yes, provide details:
By clicking the submit button below, I cerity that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I'm under contract, my contract may be terminated at any time.
Should be Empty:

MID-EASTERN ATHLETIC CONFERENCE FOOTBALL OFFICIATING APPLICATION

A: Personal Information

B: Football Officiating Experience

C: Officiating References:

D: Officiating Schedule

E: Professional and Officiating Resume:

F: Criminal and Financial Background History: