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Fall 2001 Availability Questionnaire

Availability Questionnaire

Fall 2001 Season

Please complete and submit prior to August 12, 2001.

Referee Name

E-mail Address

Social Security Number (ex. xxx-xx-xxxx)

Date of Birth (ex. 01/01/1950)

Phone Numbers:

Experience: I a current USSF certified referee. I attained my current grade of on . Recertification last completed on . I have been a VHSL certified referee since Spring, .

I am generally available on the following days and times
Sunday        
Monday
3:30
 4:00
Tuesday
3:30
 4:00
Wednesday 3:30 4:00
Thursday 3:30 4:00
Friday 3:30 4:00
Saturday morn aft
(select all that apply).

I can leave from the following location at (ex. 17:00) on weekdays.

I would like to work matches on days most weeks.

Other assignment desires include

I have a personal conflict (attendance, previous attendance, relative, etc.) with the following: .

I am available and would like to work on the following match dates that I have checked. I have checked the time I could arrive at a Richmond area field on these dates. (Amelia Academy, Goochland MS, ChristChurch, and St. vincent's de-Paul High School are out of area.)

Sunday Monday Tuesday Wednesday Thursday Friday Saturday
    9/4 9/5 9/6 9/7 9/8
  9/10 9/11 9/12 9/13 9/14 9/15
  9/17 9/18 9/19 9/20 9/21 9/22
  9/24 9/25 9/26 9/27 9/28 9/29
  10/1 10/2 10/3 10/4 10/5 10/6
  10/8 10/9 10/10 10/11 10/12 10/13
  10/15 10/16 10/17 10/18 10/19 10/20
  10/22 10/23 10/24 10/25 10/26 10/27
  10/29 10/30 10/31 11/1 11/2 11/3
  11/5 11/6 11/7 11/8 11/9 11/10

You may wish to print a copy of the table above prior to submitting. You will NOT get a return copy of this information.