2019 Women’s Referee Availability Form – Club Spring 2019 Women's Club Availability Form First Name* Last Name* Full Name* Street or Mailing Address* City* State* Zip Code* Cell Phone Number* Home Phone Number Work Phone Number Primary E-mail Address* Secondary E-mail Address (if available) What is the best way to contact you?* (Select One) Email Cell Phone Home Phone Work Phone What is the best time of day to contact you?* (Select One) Anytime Mornings Afternoons Evenings Do you have an family member currently competing in water polo at the NCAA level (player or coach)?* (Select One) Yes No Please list the name, relation and institution of the family member here (if applicable) What is your Alma Mater (name of the institution and your class year)?* Are you currently married?* (Select One) Yes No Please provide your spouse's name here (if applicable) Do you have an active NASO Membership (National Association of Sports Officials)* (Select One) Yes No Polo Shirt Size* (Select One) Unisex Small Unisex Medium Unisex Large Unisex X-Large Unisex 2XL Unisex 3XL Women's Small Women's Medium Women's Large Women's X-Large When completing your availability form it is imperative that you include your full last name, first initial and preference number for each event you select for that weekend. Example, John Smith’s first choice for a particular weekend should be listed as “Smith, J 1” and his second choice as “Smith, J 2” in the space provided after the event. If he is only selecting one event on a weekend it should still be listed as “Smith, J 1” in the space provided after that event. February 2-3 (Sat.-Sun.) Pacific Coast Division - UC Santa Barbara, Santa Barbara, CA (16 gms) ~tentative February 2-3 (Sat.-Sun.) Southeast Division - Florida State University, Tallahassee, FL (16 gms) February 2-3 (Sat.-Sun.) Texas Division - Rice University, Houston TX (12 gms) February 9-10 (Sat.-Sun.) Big Ten Division - University of Michigan, Ann Arbor, MI (18 gms) February 9-10 (Sat.-Sun.) Mid-Atlantic Division - West Chester University, West Chester, PA (12 gms) ~tentative February 9-10 (Sat.-Sun.) Rocky Mountain Division - TBD (12 gms) ~tentative February 16-17 (Sat.-Sun.) Atlantic Division - Virginia Tech, Blacksburg, VA (10 gms) February 16-17 (Sat.-Sun.) Midwest Division - Washington University in St. Louis, St. Louis, MO (10 gms) ~tentative February 16-17 (Sat.-Sun.) New York Division - Colgate University, Hamilton, NY (12 gms) February 16-17 (Sat.-Sun.) Northwest Division - Oregon State University @ Osborne Aquatics Center, Corvallis, OR (16 gms) ~tentative February 16-17 (Sat.-Sun.) Sierra Pacific Division TBD (22 gms) ~tentative February 16-17 (Sat.-Sun.) Southwest Division - Arizona State University, Tempe, AZ (18 gms) February 23-24 (Sat.-Sun.) New England Division - Northeastern University, Boston, MA (14 gms) February 23-24 (Sat.-Sun.) Southeast Division - Emory University, Atlanta, GA (14 gms) ~tentative February 23-24 (Sat.-Sun.) Texas Division - Rice University, Houston TX (12 gms) March 2-3 (Sat.-Sun.) Heartland Division - Carleton College, Northfield, MN (6 gms) ~tentative March 2-3 (Sat.-Sun.) Midwest Division - Miami University-Ohio @ Site TBD in Cincinnati, OH (10 gms) ~tentative March 2-3 (Sat.-Sun.) New York Division - Cornell University, Ithaca, NY (12 gms) March 2-3 (Sat.-Sun.) North Atlantic Division - Yale University, New Haven, CT (16 gms) ~tentative March 2-3 (Sat.-Sun.) Pacific Coast Division - Cal Poly State University, San Luis Obispo, CA (16 gms) March 2-3 (Sat.-Sun.) Rocky Mountain Division - US Air Force Academy, Colorado Springs, CO (12 gms) ~tentative March 9-10 (Sat.-Sun.) Heartland Division - St. Mary's University in MN, Winnona, MN (8 gms) March 9-10 (Sat.-Sun.) North Atlantic Division - Middlebury College, Middlebury, VT (8 gms) March 9-10 (Sat.-Sun.) Northwest Division - University of Oregon @ Willamalane Center, Springfield, OR (16 gms) ~tentative March 16-17 (Sat.-Sun.) Sierra Pacific Division TBD (22 gms) ~TENTATIVE March 23-24 (Sat.-Sun.) Atlantic Division - James Madison University, Harrisonburg, VA (10 gms) March 23-24 (Sat.-Sun.) Mid-Atlantic Division - Carnegie Mellon University, Pittsburgh, PA (12 gms) ~tentative March 30-31 (Sat.-Sun.) Big Ten Division - University of Iowa, Iowa City, IA (18 gms) March 30-31 (Sat.-Sun.) Midwest Division - Lindenwood University @ St. Peters Rec Plex, St. Peters, MO (14 gms) March 30-31 (Sat.-Sun.) North Atlantic Division - Bowdoin College, Brunswick, ME (8 gms) ~tentative March 30-31 (Sat.-Sun.) Southwest Division - Univ. of California - San Diego, San Diego, CA (16 gms) April 6-7 (Sat.-Sun.) Heartland Division - Augustana College, Rock Island, IL (8 games) April 6-7 (Sat.-Sun.) Mid-Atlantic Division Championship - Penn State University, State College, PA (9 gms) April 6-7 (Sat.-Sun.) New England Division - Boston University, Boston, MA (14 gms) April 6-7 (Sat.-Sun.) Sierra Pacific Division Championship - University of CA - Sant Cruz, Santa Cruz, CA (17 gms) ~tentative April 6-7 (Sat.-Sun.) Southeast Division Championship - University of Florida, Gainesville, FL (12 gms) April 13-14 (Sat.-Sun.) Atlantic Division Championship - University of Virginia, Charlottesville, VA (8 gms) April 13-14 (Sat.-Sun.) Big Ten Division Championship - Purdue University, West Lafayette, IN (15 gms) ~tentative April 13-14 (Sat.-Sun.) Heartland Division Championship - Grinnell College, Grinnell, IA (8 gms) April 13-14 (Sat.-Sun.) Midwest Division Championship - University of Notre Dame, South Bend, IN (15 gms) April 13-14 (Sat.-Sun.) New England Division Championship - Williams College, Williamstown, MA (12 gms) April 13-14 (Sat.-Sun.) New York Division Championship - Columbia University, New York, New York (9 gms) April 13-14 (Sat.-Sun.) North Atlantic Division Championship - MIT, Cambridge, MA (12 gms) ~tentative April 13-14 (Sat.-Sun.) Northwest Division Championship - University of Washington @ Rogers High School, Puyallup, WA (12 gms) April 13-14 (Sat.-Sun.) Pacific Coast Division Championship - UCLA, Los Angeles, CA (12 gms) April 13-14 (Sat.-Sun.) Southwest Division Championship - San Diego State University, San Diego, CA (15 gms) ~tentative April 13-14 (Sat.-Sun.) Texas Division Championship - Texas A&M University, College Station, TX (9 gms) April 19-20 (Fri.-Sat.) Rocky Mountain Division Championship - University of Denver, Denver, CO (9 gms) April 27-28 (Sat.-Sun.) DIII National Collegiate Club Championship - Site TBD (Selection) May 3-5 (Fri.-Sun.) National Collegiate Club Championship - Atlantic Division Site TBD (Selection) If you confirmed you filled out your contact information properly and also selected all sites you are available, please click the below submit button in order for your form to be received. If done properly, you will be redirected to the Officiating Forms page. Submit Club Referee Form