Tacoma - Pierce County Volleyball Officials Board

TACOMA-PIERCE COUNTY VOLLEYBALL OFFICIALS BOARD
Rating Request Form

I, would like to be considered for my rating.
Email:	Phone:	Cell Phone:

CERTIFIED/NCAA LOCAL CRITERIA

I have officiated Junior High matches:
1. Date	2. Date	3. Date	4. Date	5. Date
I have officiated AA or A/B High School matches as 2nd referee:
1. Date	2. Date	3. Date	4. Date	5. Date
I have officiated AA or A/B High School JV matches as 1st referee:
1. Date	2. Date	3. Date	4. Date	5. Date

CERTIFIED/NCAA STATE CRITERIA

I have officiated AAA or AA High School matches as 1st referee:
1. Date	2. Date	3. Date	4. Date	5. Date
I have officiated AAA or AA High School matches as 2nd Referee:
1. Date	2. Date	3. Date	4. Date	5. Date
I have officiated Intercollegiate matches as 2nd referee:
1. Date	2. Date	3. Date	4. Date	5. Date

Theoretical Exam
State min. 82
Local min. 76

I have/have not passed my exam on (date) score

Practical Exam
State min. 85
Local min. 80

I have/have not passed my exam on (date) score

You have met/have not met observation with a successful report.

You have met/have not met requirements to be rated for

Board Member: Date:

Address: 9908 63rd Ave Ct E., Puyallup, WA 98373 | Phone: 253-848-1360 | Fax: 253-848-3317 | Cell: 253-677-2872