WUSC Summit Cup
June 19 - 21, 2009

Referee Availability Form

Please submit availability information by May 29th*

*You are welcome to submit your form after the due-date with the understanding that you might not receive initial assignments.
Please fill in ALL the requested information below and click the "Submit" button to be added to the Tournament Referee List

Personal Information:
Required Fields are RED (the form won't be sent if any Required Fields are left blank)

             Please enter your name as it appears on the OregonSoccerCentral website
First Name: Middle Initial: Last Name:
Age (if under 18): (If over 18 you may list "adult")
E-Mail Address:
Street Address:
City: , State: ZIP Code:
Telephone Numbers:
(include Area Code)		 (select
preferred) 		Your approximate
Referee Experience:
Home: Time:
Work: Number of Centers
(last 12 months):
Cell: Highest level I feel
comfortable as a
Center Referee 
Current Referee Grade:
Highest level I feel
comfortable as an
Assistant Referee 

Tournament Information:
WUSC Summit Cup
West Linn, Tualatin
U10 - U15 Boys and Girls
Referees will be paid at tournament headquarters
Assignor: Janet Irigoyen
Availability Information:
You must be 2009 USSF Registered to officiate at this tournament

Select the times you are available
for the dates you are available
Friday
June 19
 Saturday
June 20
 Sunday
June 21
from
 until 		 from
  until 		 from
  until

How many games per day do you want to do?      2 3 45+
How many games in a row do you want to do?     2 3 4+

Which positions do you want to work?      Center and Assistant Assistant (Lines) ONLY

            What age groups do you      U10     U11     U12  
            prefer to work with?            U13     U14     U15   

Player/Parent/Coach Conflict Information:
           If you have a conflict with any team, list that information here:
                  Club Name:   Team Name:  
                  Age-group:     Gender:
                  Do you want to be assigned at the same time this team plays: No    Yes

Comments: (transportation issues, preferred work partners, etc.)

Note: If you want to save a record of your information click the "Print This Page" button before clicking the "Submit" button Once successfully submitted the information on this page is reset  to default when you return to it.

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