Officials Application Form

                   2007 USATF Southern Association Championships (Youth  Masters)

                   2007 USATF Southern Association J.O. Championships

Name: _________________________________________________________________

                      Last                                               First                                                    Middle

Address: ______________________________ E-mail: __________________________

City: _________________________State: ______________Zip Code: _____________

Cell Phone: ______________________ Home Phone: __________________________

Association________________ Certification #____________   Level_______________

Years of officiating Experience: _____________ Shirt Size: S M   L   XL    3X     4X  

Events you prefer to officiate:

1._______________________ 2._______________________ 3. ____________________

Check meet(s) you can work:

-----Southern Association Championship- June 9 (Youth and Masters) in

       Baton Rouge, LA

___ Southern Association J.O. Championship - June 21/22 (combined events)    

___ Southern Association J.O. Championship - June 23/24 in Baton Rouge, LA

___ Yes, I am available to work all day for both meets.

___ Yes, I will like to work, but I am unable to work all day. Please indicate which

        meet.

___________________ Meet_______ _Morning only _____________ Afternoon only

____No, I am not available to work June 9 or June 21-24 Championship Meets.                        

Signature____________________________________ Date______________________

Please return this form by March 1, 2007 via mail, fax (337-237-9190), e-mail, marialouis1@aol.com or mail at 532 Raintree Trail Lafayette, LA 70507

Gloria Louis                                        Meet Director                  Meet Director                                            

Coordinator of Officials                 Trent Ellis –June 9       Roderick Newton- June 21  

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