Speed Capital 2022 Meet Officials Application Form
Name
*
Address
*
Address
Street Address Line 2
City
State
Postal / Zip Code
Zip Code
*
Telephone
*
Format: (000) 000-0000.
E mail Address
*
example@example.com
Please check off the Speed Capital event(s) you are available to work
*
2/26 - 2/27 SC South Florida Season Opener Miramar
3/19- 3/20 SC Southeast InvitationalAtlanta
3/26 - 3/27 SC North Florida Invitational Jacksonville
5/14 - 5/15 SC Louisiana Invitational New Orleans
5/14 - 5/15 SC New York-Baldwin
5/21 - 5/21 SC Michigan -Detroit
5/28 - 5/29 SC Florida Memorial-Miramar
5/28 - 5/29 SC Virginia Memorial-Ashburn
5/28 - 5/29 SC California Memorial-Covina
5/28 - 5/29 SC Ohio Memorial-Cincinatti
6/04 - 6/05 SC Illinois Invitational-Lisle
6/04 - 6/05 SC Central Alabama-Birmingham
6/11 - 6/12 SC Indiana Invitational Indianapolis
06/11 -06/12 SC South East Series Championship Orlando (FL Elite) Florida
06/30 - 7/3 South West Series ChampionshipTBD
7/07 - 7/10 SC National Championship
Please choose 1 category that best describes you:
*
Please Select
Apprentice,
Association,
National,
Master
1] Select Four (4) Events by Priority in which you are best qualified: 1st
*
Please Select
Finish Judge
Discus
Javelin
Shot Put
Pole Vault
Starter
High Jump
Clerk
Race Walk
Long Jump
Triple Jump
Umpire
Track Referee
Field Referee
Implement Inspector
Lap counter
2] Select Four (4) Events by Priority in which you are best qualified: 2nd
*
Please Select
Finish Judge
Discus
Javelin
Shot Put
Pole Vault
Starter
High Jump
Clerk
Race Walk
Long Jump
Triple Jump
Umpire
Track Referee
Field Referee
Implement Inspector
Lap counter
3] Select Four (4) Events by Priority in which you are best qualified: 3rd
*
Please Select
Finish Judge
Discus
Javelin
Shot Put
Pole Vault
Starter
High Jump
Clerk
Race Walk
Long Jump
Triple Jump
Umpire
Track Referee
Field Referee
Implement Inspector
Lap counter
4] Select Four (4) Events by Priority in which you are best qualified: 4th
*
Please Select
Finish Judge
Discus
Javelin
Shot Put
Pole Vault
Starter
High Jump
Clerk
Race Walk
Long Jump
Triple Jump
Umpire
Track Referee
Field Referee
Implement Inspector
Lap counter
Please Select Shirt Size:
*
Please Select
S
M
L
XL
XXL
XXXL
RECENT OFFICIATING HISTORY (if none type' None' )
1
*
2
3
4
Do you have any food allergies?
*
Please Select
Yes
No
How are you travelling to the meet?
*
Please Select
Car
Bus
Train
Plane
Roommate Preference ?(Please specify)
Do you have an athlete or team competing in this event? :
*
Please Select
Yes
No
Emergency Contact Name:
*
Emergency Contact Tel. Number
*
Please let us know if you have any other special requests or information to share with the officials coordinator:
USATF#
*
Signature
*
Date
*
/
Month
/
Day
Year
Date
SCAN A COPY OF YOUR USATF CARD TO SEND WITH THIS APPLICATION
SCAN A COPY OF YOUR USATF CARD TO SEND WITH THIS APPLICATION
*
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