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NORTHERN LIGHTS QUALIFIER TOURNAMENT APPLICATION
2012
Application Due: March 1, 2012
BACKGROUND SCREENING FORMS MUST BE ON FILE WITH YOUR REGION
Name:
Address:
City: State: Zip:

E-Mail:

Home Phone: Work Phone:

Cell Phone:

All Officials
Out of Metro Area Officials

USAV Certification (Required)

Hotel Required?

Preferred Roommate:

Region Affiliation:

USAV Number: (Required)

Date of Birth: (Required)

Are you driving?

If "Yes", list others in the vehicle: (It is imperative for hotel assigments that we know who is traveling together) If this information changes before your arrival please let us know immediately.

Shirt Size:

 
Availability - 1st Weekend (12, 13, 16, 17, 18)

Friday, April 13 AM (8am - 3pm) --or-- PM (3pm - 9pm) --or-- ALL DAY
Saturday, April 14 AM (8am - 3pm) --or-- PM (3pm - 9pm) --or-- ALL DAY
Sunday, April 15 ALL DAY
COMMENTS/SPECIAL REQUIRMENTS
  • Each official will be notified of their status no later than March 10th via e-mail.
  • The criteria used for scheduling assignments are based on Certification, History and Availability.
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Availability - 2nd Weekend (14, 15)
Friday, April 20 AM (8am - 3pm) --or-- PM (3pm - 9pm) --or-- ALL DAY
Saturday, April 21 AM (8am - 3pm) --or-- PM (3pm - 9pm) --or-- ALL DAY
Sunday, April 22 ALL DAY
COMMENTS/SPECIAL REQUIRMENTS
  • Each official will be notified of their status no later than March 10th via e-mail.
  • The criteria used for scheduling assignments are based on Certification, History and Availability.