KANSAS SHOWCASE
 Soccer Tournament
 June 25-26, 2011

REFEREE APPLICATION
Submitting an application
does not guarantee acceptance
Please complete the following:
First Name:   Last Name:
Birthdate:   Age:
Address:
City:   State:    Zip:
Home Phone xxx-xxx-xxxx:    Work Phone:    Cell Phone:
Do you have text messaging?: Yes  No   Fax Number:  
Primary email:
Alternate email:
Current Referee Grade: 
What is the oldest group and level you are comfortable working as a Center Referee?
U10    U12    U13    U14    U15    U16    U18    U19       Boys  Girls
What is the oldest group and level you are comfortable working as an Assistant Referee?
U10    U12    U13    U14    U15    U16    U18    U19       Boys  Girls
What is your availability?
Saturday, June 25, 2010 All Day (7:30am-8:00pm)
Afternoon (Noon-4:30pm)  		Morning (7:30am-Noon)
 Evening (4:00-Last Games)
Sunday, June 26, 2010 All Day (7:30am-8:00pm)
 Afternoon (Noon-4:30pm) 		Morning (7:30am-Noon)
 Evening (4:00-Last Games)
Please provide complete details if you will be playing, a spectator, coaching or have any other conflicts.  Also, provide any notes regarding assignments: