JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2019 Winter California-Nevada Sectional Championship Application to Officiate
December 13-16, 2019
Sponsored by USA Swimming & Southern California Swimming
Hosted by: Fullerton Aquatic Swim Team (FAST)
East Los Angeles College (ELAC) 1301 Avenida Cesar Chavez, Monterey Park, CA
Fullerton Aquatic Swim Team and Southern California Swimming invite you to officiate at the 2019 USA Swimming Speedo Championship Series Winter CA-NV Summer Sectional Championship to be held at the East Los Angeles College Aquatic Center in Monterey Park, CA. This meet has been designated as an "Officials Qualifying Meet" for N2 and N3 evaluations. A mandatory officials' briefing will be held prior to each session. To be considered for an assigned position, this application must be received no later than November 22, 2019. (You will receive confirmation of your assignment by November 25th).
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Applicants Name:
*
Your answer
LSC
*
Your answer
Cell Phone:
*
Your answer
Address:
*
Your answer
City, State, Zip:
*
Your answer
Highest N2 Certification
*
Your answer
N2 Expiration Date:
*
MM
/
DD
/
YYYY
Highest N3 Certification
*
Your answer
N3 Expiration Date:
*
MM
/
DD
/
YYYY
Years/Months at Highest level:
*
Your answer
Applicant must be a member of USA Swimming and an LSC certified Official
Uniform is white polo and khaki short or long pants or skirt with white shoes and socks for prelims. Oxford blue button down shirt/blouse over khaki pants or skirt with white shoes and socks for finals. If the temperature is expected to be over 90 degrees F, shorts may be worn for finals.
Sessions available to serve:
All Sessions
Friday, December 13 Prelims
Friday, December 13 Finals
Saturday, December 14 Prelims
Saturday, December 14 Finals
Sunday, December 15 Prelims
Sunday, December 15 Finals
Monday, December 16 Prelims
Monday, December 16 Finals
.
All Sessions
Friday, December 13 Prelims
Friday, December 13 Finals
Saturday, December 14 Prelims
Saturday, December 14 Finals
Sunday, December 15 Prelims
Sunday, December 15 Finals
Monday, December 16 Prelims
Monday, December 16 Finals
.
Assigned position desired:
If you would like to be considered for an assigned position, please check the appropriate box below. If applying for more than one position, please indicate preference (1,2,3)
Assignment Request
Deck Referee
Starter
Chief Judge
Asst. Admin. Referee
Mulitple request preference order
Your answer
APPLICATION FOR EVALUATION:
If you would like to be oberved/evaluated during the meet, complete the following:
Evaluation Requested
For Advancement to N2
For Advancement to N3
For Education
Referee
Starter
Chief Judge
Admin Referee
Stroke and Turn
Re-certification Requested
For Recertification at N2
For Recertification at N3
Referee
Starter
Chief Judge
Admin Referee
Stroke and Turn
Untitled Title
For an N3 evaluation to be valid it must be done over 4 sessions in the position. N2 evaluations must be done over 3 sessions in the position. Recertification evaluations must be done over two sessions, however, the official must work at least 4 sessions at the meet for the recertification evaluation(s) to be valid. Only one position for an official may be evaluated in each session, although officials in a "rotation" may work in other positions in an evaluation session
Shirt Size for host planning only
Shirts may not be available for entries after the application deadline November 22, 2019.
Women's
S
M
L
XL
XXL
XXXL
Clear selection
Men's
S
M
L
XL
XXL
XXXL
Clear selection
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
