Returning or Transferring Referee Application

Name

First NameLast Name

If previously a USAPL member and may have gone by a nick name or another name please enter it here.

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Date

Were you ever a USA Powerlifting member?

Please enter your member number if you remember it.

Were you ever a USA Powerlifting referee?

What level of referee were you for USA Powerlifting?

Approximately how long were you a referee for USA Powerlifting

Are you currently or have you ever been a referee for any other federation?

What level of referee were you for any other federation?

Approximately how long were you a referee for any other federation(s) combined?

Please provide a short but detailed resume outlining your referee experience. This doesn't have to look professional. We just need the information. The list below outlines some of (but is not limited to) the info we need.

Time involved in powerlifting (If any).
Which federation(s) you were a referee for.
Rank of referee for each federation.
Approx time in each rank for each federation.
Please feel free to leave any comments on why you are either deciding to come back to USAPL or why you are deciding to become a referee for USAPL. This will not influence our decision. We would just like to know for our own internal data. It can even be as simple as "I just want to referee for multiple federations".
Any other Comments

File Upload

Based on your current referee rank, which rank are you applying for. (You can not apply for a rank that you have not already previously held for USAPL or any other federation).