2020 AAU Racewalk National Championship

2020 AAU Racewalk
National Championship

Officials Application

December 5, 2020

Apalachee Regional Park
7550 Apalachee Pwy
Tallahassee, Florida 32311

Questions?
Contact
Tracey Tomlinson
aauracewalkcommittee@gmail.com
727-342-3684

First Name:*

Last Name:*

Gender:*

Male

Female

E-mail:*

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Address:*

Street Address City State / Province / Region Postal / Zip Code

Primary Phone:

Area Code

-

Phone Number

Type:*

Home

Work

Cell

Secondary Phone:

Area Code

-

Phone Number

Type :

Home

Work

Cell

Name of Emergency Contact:*

First

Last

Phone of Emergency Contact:*

Area Code

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Phone Number

List any allergies, medications, or medications we should be aware of:

Certification Number/ID:

USATF Certified:
Please select four (4) areas you would like to work in order of preference (DO NOT select same area for all 4 choices)

Preference 1:*

Preference 2:*

Preference 3:*

Preference 4:*

Please select all the days you will be available:*

Saturday, 12/5

How will you be traveling?: *

Air

Car

Other (Explain below)

Other travel arrangements:

Noteworthy Accomplishments:

Please inform us of any special dietary requests.

Request:*

I have no special dietary requests

I am a vegetarian

Other (explain below)

Dietary Explanation

Are you competing and/or do you have an athlete or team competing in this event?"*

Yes

No

Please let us know if you have any other special requests or information to share with the officials coordinator:

Please upload a headshot and picture of BOTH SIDES of your official's certification credentials. File formats accepted (jpg, jpeg, png, gif, doc, docx, xls, xlsx). Max upload 2MB.

Please ensure you have provided an accurate email before submitting your application. This will be the primary form of communication for informing you of your application status.