2004 Vsi Short Course Senior Championship Meet s1

2009 VIRGINIA SWIMMING SHORT COURSE SENIOR CHAMPIONSHIP MEET

-APPLICATION TO OFFICIATE & REQUEST FOR NATIONAL OFFICIALS EVALUATION-

5-8 March 2009, Aquatic & Fitness Center, University of Virginia, Charlottesville, VA

Can be filled in using Microsoft Word, saved with a new file name, and e-mailed as an attachment.

Name: Club/LSC:

E-mail Address:

Home Phone: Work Phone:

Current LSC Certification(s): Years Certified:

Current N2 Certification and Expiration:

Current N3 Certification and Expiration:

I will serve at all sessions: Yes No

I can’t serve at all sessions. My choices for individual sessions are checked below:

Thursday: Finals

Friday: Prelims Finals

Saturday: Prelims Finals

Sunday: Prelims Distance Finals

Please check your assignment request:

Deck Referee, Admin Referee, Starter, Chief Judge

Stroke & Turn, CTS Operator, Timing Judge, Recorder

For assigned positions (Referee, Starter, Chief Judge), officials who will work all sessions will be given priority. Assigned officials must be available for prelims and finals of each day worked.

All officials must attend mandatory briefing one hour before each session being worked.

APPLICATION FOR EVALUATION: This meet has been approved as an Officials Qualifying Meet with evaluations available as indicated in this section. Please complete this section of the application and forward it to the Meet Referee if you would like to be evaluated during the meet:

N2 N3 N3 Initial N3 Recert N3 Final*

Stroke & Turn - - -

Chief Judge -

Starter - -

Deck Referee -

Admin Referee - - - -

Order of preference if multiple evaluations requested:

* Evaluation provisionally granted pending evaluator’s opinion that the meet supports the evaluation level.

All evaluations require working a minimum of 4 sessions to be valid. N2 evaluations require that at least 3 of the sessions be in the position being evaluated. N3 initial and final evaluations require evaluation over 4 sessions in position. Recertification evaluations require evaluation over 2 sessions in position.

Embroidered meet event officials shirts (blue, button-down, Oxford from Land’s End – suitable for finals) will be available on a pre-ordered, pre-paid basis.

Men’s Regular ($29): S (14-14 1/2), M (15-15 1/2), L (16-16 1/2), XL (17-17 1/2), XXL (18 -18 1/2)

Men’s Big ($34): 2XL (18 -18 1/2), 3XL (19-19 1/2), 4XL (20-20 1/2), 5XL (21 -21 1/2)

Women’s Regular ($29): XS (4), S (6-8), M (10-12), L (14-16), XL (18-20)

Women’s Plus ($34): 1X (16W-18W), 2X (20W-22W), 3X (24W-26W),

Make checks payable to: VSI

Order must be received no later February 15, 2009.

The deadline for receipt of this application to be considered for specific assigned positions (Deck Referee, Admin Referee, Starter, Chief Judge) is no later than February 21, 2009. Assigned positions will be notified no later than February 24, 2009. Applications for non-specific deck and administrative positions will be accepted until the positions are filled.

Mail to: Pat Donohue, 9636 Weston Lane, Richmond, VA 23238

E-mail to:

FAX to: 804-740-6400