6th Annual High School Football Officials Clinic
Sponsored by West Michigan Officials Association
August 19, 20 and 21, 2010
at East Kentwood High School
Football Clinic Registration (old)
Registration for 2011
Last Name
First Name
MHSAA#
Affiliation/Association
WMOA past/current member
YES
NO
Street Address
City
State
MI
IN
OH
ZIP code
Home Phone
Work Phone
Mobile Phone
Email
*
Confirm
*
Email (optional secondary)
Name of Crew Chief
Desire to work a scrimmage
YES
NO
Preferred day
Thursday
Friday
no preference
Preferred time
3:00pm
6:00pm
no preference
Years of experience
0-1
2-5
6-9
10+
Primary position
R
U
LJ
HL
BJ
Secondary position
R
U
LJ
HL
BJ
Desired position for scrimmage
R
U
LJ
HL
BJ
Registration Status/Fees
1st yr MHSAA Registered Official($20)
registration($35)
registration after August 8 ($50 total)(includes late fee)
Shirt size
M
L
XL
2XL
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