Officials Selected to Work the Meet Will Receive a Stipend

You’re invited to apply to officiate at the 2017 Ohio Senior Games Track and Field Championships, at Otterbein University in Westerville, Ohio on June 23rd (Throwing Events) and June. 24th (Jumping and Running Events)

Officials selected to work the meet will receive a stipend.

Last Name First Name Gender: M/F Home Phone Cell Phone

Address City State Zip E-mail Address

Certification Level Official Certification # (Certification is not required for selection.) List any physical limitations: ______

Officiating event preference/area of expertise: Enter “1” “2” “3” in order of your preference:

____ Clerk of Course ____ Horizontal Jumps ____ Vertical Jumps ____ Javelin and Shot Put ____ Discus & Hammer ____ Field Referee ____ Starter ____ Race Walk

Officiating Experience: Starting with the most recent, list up to eight significant competitions you have officiated during the past 2-3 years. Use the form below; please do not include attachments.

Month & Officiating Duty Year Meet Name Meet Location (& indicate crew or head)

Send to the Landen Lama Officials’ Coordinator by e-mail to: [email protected] or by US mail to 118 Pryor Rd Lancaster, Ohio Phone: (614) 395-8512 L We expect to notify applicants of selections by 6/9/17

Ofcls Applctn Template, USATF Best Practices, Dec 11 (Credit: R. Schornstein)