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Spring 2004 Availability Questionnaire

Please complete and submit prior to January 31, 2004. Update any changes as they occur using the separate UPDATE AVAILABILITY form.

Referee Name

E-mail Address (preferred)

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

Date of Birth (ex. 01/01/50)

Contact Information:

  Number Call Between Preferred?
Home Phone
Work Phone
Mobile/Cell
Pager
Fax Check here if a cover page is required
Home e-mail
Work e-mail
Home Zip Code
Work Zip Code

I would like to work matches on days most weeks.

I am generally available on the following days and times (Select all that apply. Check the time YOU CAN LEAVE FOR THE FIELD.).
Monday
3:30
 4:00 4:30 5:00 5:30
Tuesday
3:30
 4:00 4:30 5:00 5:30
Wednesday 3:30 4:00 4:30 5:00 5:30
Thursday 3:30 4:00 4:30 5:00 5:30
Friday 3:30 4:00 4:30 5:00 5:30
Saturday morn aft            

I usually can leave from the following location (city, street, zip, be specific) at (ex. 17:00) on weekdays.

 

Other assignment desires include

I have a personal conflict of interest (due to attendance, graduation, relative, etc.) with the following schools: .

Please check the dates below that you CANNOT work during the season. The assignor will presume you are available on the other dates not selected. If you are available only part of a day, or need to supply the assignor with additional information, use the text field below. CHECK A BOX IF YOU CANNOT WORK THAT DAY!

Monday Tuesday Wednesday Thursday Friday Saturday
Scrimmage Matches 3/1 through 3/15

3/1

 

3/2

3/3

 

3/4

 

3/5

 

3/6

 

3/8

 

3/9

 

3/10

 

3/11

 

3/12

 

3/13

 

Regular Season Begins March 15

3/15

 

3/16

 

3/17

 

3/18

 

3/19

 

3/20

 

3/22

 

3/23

 

3/24

 

3/25

 

3/26

 

3/27

 

3/29

 

3/30

 

3/31

 

4/1

 

4/2

 

4/3

 

Public School Spring Break -- Some Private School matches

4/5

 

4/6

 

4/7

 

4/8

 

4/9

 

4/10

 

4/12

 

4/13

 

4/14

 

4/15

 

4/16

 

4/17

 

4/19

 

4/20

 

4/21

 

4/22

 

4/23

 

4/24

 

4/26

 

4/27

 

4/28

 

4/29

 

4/30

 

5/1

 

5/3

 

5/4

 

5/5

 

5/6

 

5/7

 

5/8

 

5/10

 

5/11

 

5/12

 

5/13

 

5/14

 

5/15

 

5/17

 

5/18

 

5/19

 

5/20

 

5/21

 

5/22

 

Post season play begins 05/24

5/24

 

5/25

 

5/26

 

5/27

 

5/28

 

5/29

 

5/31 6/1 6/2 6/3 6/4 6/5

Additional information for assignor:

Please check your work. Are you sure you checked the boxes on days you CANNOT work?

You will get a copy of the data you submitted. You should print this for your records. You will also get a confirmation from the assignor when he has received your availability form. If you do not receive a confirmation within 3 days of sending your form, contact the assignor.