2014Atlantic Sun Conference
MEN AND WOMEN INDOOR TRACK AND FIELD MEET
JDL FAST TRACK
2505 EMPIRE DRIVE
WINSTON-SALEM, NC 27103

The Meet will be held on February 21 - 22, 2014

Part A. Please print legibly or type all information
Application must bepostmarked on or before January 1, 2014
Name______USATF ID: ______(6 digits)
First M Last
Address______Certification Level: ______
City: ______State__ __ Zip Code: ______-____
Telephone: (___) ______Gender: M _ F _ USATF Membership #______(10 Digits)
)
10 digit
Shirt Size: _____
Email Address: ______(This is important since most correspondence will be by e-mail)

Part B: Officiating Preferences: For each event you would like to be considered to work place your preference number to the left of event name. (1 for first choice; 2nd for second; 3rd choice ) Please indicate more than one. Show your top 5. Prior experience will influence assignments. You may be asked to work at one or more events.

Track Events: Field Events: Other specializations:

a: __Finish Line/Lap/Timing/Finish f: __Throws j: __ Marshal/Steward

b: __Clerk or Course/Call Roomg: __Horizontal Jumps k: __Wind Gage Operator

c: __Umpireh:__Vertical Jumps l: __ Technical Manager

d: __Starter/Recall/Start Coord. i: __ Elect. Msrmnt Judge m: __Implement Inspector

n: __ Race Walk Official/Umpire

Do you have experience with FieldLynx Yes_ No_ Throws __; Horizontal Jumps __; Vertical Jumps __

Hotel reservation request: Feb. 20 ___; Feb. 21 ___; Feb. 22___

If you request a roommate please list: ______. It would be helpful to have them list you on their application to eliminate any conflicts.

If a non- officiating person will accompany you, you will be responsible for ½ the cost of the room.

I would like to share a room with ______.

Part C: Experience starting with the most recent meets, list up to twelve significant meets that you have worked from 2011 through 2013. Indicate the date; meet location and your primary assignments.
Where your assignment matches your preference as shown in Part B:, list the preference number you are requesting.
If you worked in the Shot Put and your second preference for throws, place a 2 under “Preference”.

D

Date /

Meet Location

/

Primary Assignment

/

Preference

n preference will be given to those who can work most of the days shown

If you are selected to work you will be expected to work the entire meet. Your assignment maybe changed due to meet needs.

You may email as an attachment or mail application to

Roger Burbage

4605 Limerick Drive

Raleigh, NC 27604-3525

f housing is requested then preference will be given to those who can work most of the days shown below. First preference will be given to certified officials to fulfill these jobs, but we will need and use

Signed: ______Date: ______