North Coast Section Form C

Game Assignment Eligibility

Currently, the NCS site may be experiencing problems. As a workaround, officials can fill out the Game Assignment Eligibility FORM C here. Submitted entries will be forwarded to the appropriate personnel.

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GENERAL AVAILABILITY CONFIRMATION

Officials: Please complete this form on or before Monday, February 16, 2015

NAME *

ADDRESS *

CITY, STATE *

ZIP *

PHONE *

ASSOCIATION *

EMAIL *

1. High school that currently employs the official (if applicable)

2. High school(s) that previously employed the official (last 5 years)

3. High school(s) official attended as a student (last 10 years)

4. High school(s) that have a child of the official in attendance

5. High school(s) in which the official is a member of an auxiliary organization (booster club, P.T.A., etc.)

6. Other school(s) with which the official has a conflict

7. Do you have a child playing varsity basketball for a NCS member high school?

YES

...School:

...Gender:

BOY

GIRL

I am an independent contractor in good standing of the above accredited officials association. I understand that nominated officials are not guaranteed an assignment to a North Coast Section game. I also understand that I am an independent contractor and not an employee of the North Coast Section, its member leagues or schools. I will accept/decline all North Coast Section games offered through my assigning association per the terms of my agreement with this association as an independent contractor. I have worked a minimum of a minimum of five (5) high school varsity basketball games this season. I am available and willing to commit to officiating NCS/Les Schwab Tires Championship Series games on the following dates:

TUE, FEB 24, 2015

WED, FEB 25, 2015

FRI, FEB 27, 2015

SAT, FEB 28, 2015

WED, MAR 04, 2015

FRI, MAR 05, 2015

SAT, MAR 07, 2015

Signature

Date

YYYY

By checking this box, I confirm that the above field represents my signature:

CONFIRM: