Return to Main

Fall 2002 Availability Questionnaire

Availability Questionnaire

Fall 2002 Season

Please complete and submit prior to August 22, 2002.

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 (Note that fall season games are generally afternoon matches. Times shown below are arrival times -- typically 15 - 30 minutes before game kickoff. Identify the times you can make.):
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, Blessed Sacrament - Huguenot, are out of area, but include travel fee.)

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

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