Indiana PIF
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| Your Name
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| Address
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| City
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| State
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| Zip Code
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| Home phone
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| Work phone
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| E-mail
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| All ratings held
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| USAG #
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| Safety Certified Expiration Date
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| NAWGJ #
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| Event Preference 1
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| Event Preference 2
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| Event Preference 3
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| Event Preference 4
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| Top two highest compulsory meets judged
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| Top two highest optional meets judged
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| Top two highest symposium clinics attended
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| 2010 Training Camps worked
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Super Camp Spectator Super Camp Assigned Clinician Hot Shot Camp Spectator Hot Shot Camp Assigned Clinician High Tech Camp Spectator High Tech Camp Assigned Clincian Forward Progress Camp Spectator Forward Progress Camp Assigned Clinician
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| 2011 Training Camps worked
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Super Camp Spectator Super Camp Assigned Clinician Hot Shot Camp Spectator Hot Shot Camp Assigned Clinician High Tech Camp Spectator High Tech Camp Assigned Clincian Forward Progress Camp Spectator Forward Progress Camp Assigned Clinician
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| State meets available to judge
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Level 3/4 North State Championship: March 10 - 11, 2012 Level 3/4 South State Championship: March 10 - 11, 2012 Level 5/6 State Championship: March 17 - 18, 2012 Prep-Opt & Level 9/10 State Championship: March 24-25, 2012 Level 7/8 State Championship: March 31 - April 1, 2012
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| Regional meets available to judge
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Level 8 Regionals: April 27 - 29, 2012 Level 9-10 Regionals: April 13 - 15, 2012
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| National meets available to judge
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Level 9 Eastern Nationals: May 3 - 6, 2012 Level 10 J.O. Nationals: May 10 - 13, 2012
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| Affiliation with any meet host
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No Level 9-10 Regionals: April 13 - 15, 2012
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| If yes, please explain how.
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