Referee Communication and Availability Form by mvr5

VIEWS: 10 PAGES: 2

									                  Referee Communication and Availability Form

________________________________________________________
First Name                              Last Name                                          Other

____________________________________                  __________________ HI _______________
Address checks should be sent to                        City                   Zip Code

______________________              _________________________           _________________________
Home Phone                          Work Phone                          Cell Phone

_____________________________@__________________________._______________________
E-mail Address (Must be checked on a regular basis)

Best way to reach me. ____________________Best time to reach me._________________________

Circle your responses:
I am available for the HPA Tournament:       Friday Saturday          Sunday __________________________
I am available Saturdays: Always Sometimes Never ________________________________________
I am available Weekdays: Monday Tuesday Wednesday Thursday Friday __________________
I want to be considered for the State Tournament on Oahu:       Yes     No

As Referee (“center”): I feel I am capable of officiating this level: (Be honest with yourself!)
JV Boys JV Girls Varsity Boys         Varsity Girls Championship Game High School State Match
As Assistant Referee: I feel I am capable of officiating this level:
JV Boys JV Girls Varsity Boys         Varsity Girls Championship Game High School State Match


My referee certification is:

AYSO: none       U8    Assistant Referee     Basic     Intermediate     Advanced    National2      National
USSF: none      Grade 8     Grade 7     Grade 6      Grade 5   other (specify:___________________)
Please list any other referee certifications/badges held or describe other level of training:
_________________________________________________________________________________

I have conflicts with the following teams. (players, schools, etc.)
____________________________________________________________________________________
____________________________________________________________________________________

When I referee a game I would be traveling from ____________________________on weekdays.

When I referee a game I would be traveling from ____________________________on Saturdays.
I promise to:

      Do my best to serve the BIIF League, the game of soccer and the children of the Big Island.
      Be on time to games.
      Communicate with my fellow referees in a calm and mature manner.
      Support my fellow referees on and off the field.

    Dress appropriately for all games.
    Be ready for all usual and unusual circumstances.
    Be forthright in my calls and to leave all agendas at home.

    Study and learn from each and every game I attend.
    Record and turn in my paper work within 24 hours of each game.
    Bring my enthusiasm for the game and for my craft to every assigned game.

I understand I am under a personal contract and will be responsible for my actions. I understand that I am
responsible for all personal taxes and will receive no paid benefits other than my game fees and travel
expenses. I understand that I am an independent contractor and not an employee of the Big Island Soccer
Referee Association or BIIF.

I understand that my pay may be reduced by $5 for every game report not submitted on time.


___________________________________
Print Name

___________________________________           ________________
Signature                                      Dated




Checks made to: BISRA
Fee: $25.00; Badge: $5.00
Check no.____ Amount paid:_________



My score for the NFHS Soccer Test 2009-2010: _______%

								
To top