2022 Apprentice Official Application

2022 Apprentice Official Application

LSC: ALLEGHENY MOUNTAIN SWIMMING
Apprentice Officials must be pre-approved by AMS Officials' Chair, Scott Wilshire
This form must be submitted at least three days prior to your first on-deck shadowing session.

Apprentice Official status expires 60 days from the date of the initial training session. At the end of 60 days you must fully register as a non-athletle member of USA Swimming and comlete the USA Swimming Background Check to continue your on-deck training or become a certified official. Certified Officials are also required to complete Concussion Protocol Training.

Apprentice Officials are required to complete Athlete Protection Training prior to their first on-deck shadowing session. You must be in the SWIMS database to have access to the training. We will notify you when your application has been processed and you are able to complete the training.
Have you ever been a member of USA Swimming? *
Previous name
Maiden Name/Married Name, etc.
Last Name *
First Name *
Middle Name
Preferred/Nickname
DOB *

Month Day Year
Sex (M/F)
Club Code *
2-4 Letter Club Abbreviation
Club Name *
If not affiliated with a club, enter"Unattached"
Address *
City *
State *
Zip *
Home #
Cell # *
E-mail address *

THIS APPRENTICE OFFICIAL STATUS EXPIRES 60 DAYS FROM THE DATE OF THE INITIAL TRAINING SESSION. CONTACT YOUR LSC OFFICIALS CHAIR FOR FURTHER INSTRUCTIONS.

By signing Below *

I acknowledge that I have reviewed and agree to abide by rules and regulations of the Minor Athlete Abuse Prevention Policy I acknowledge that I am compliant with the PA State Clearance Requirements for Volunteers
Signature *

Clear
Today's Date *

Month Day Year
Initial Shadowing Date *
First planned shadowing session
Should be Empty: