Umpire Sanction Form USA SOFTBALL of NC

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Umpire Sanction Form USA SOFTBALL of NC

www.registerASA.com   visit site for required background check $11.00 cost

SANCTION FEE: $45.00  

also found for PDF download at: http://www.usasoftballnc.com/umpires

 

 

 

 

NAME _______________________________________________________________________

ADDRESS _____________________________________________________________________

CITY ____________________________________ STATE ________ ZIP ___________________

DOB _____/______/___________                                     GENDER:      MALE______      FEMALE_____

EMAIL ADDRESS________________________________________________________________

ALTERNATE EMAIL ADDRESS _____________________________________________________

PRIMARY CONTACT NUMBER _(________)_________________________________________

WHO IS YOUR ASA UMPIRE ASSIGNER? _____________________________________________

USA SOFTBALL (ASA) EXPERIENCE:       YEAR YOU FIRST REGISTERED in

SLOW PITCH _______                             FAST PITCH ______                      MODIFIED _______

WHICH DO YOU PREFERE TO UMPIRE?  FP_____   SP_____    MODIFIED______  ANY ______

HAVE YOU ATTENDED AN ASA NATIONAL SCHOOL?  _____________                       YEAR_______

HAVE YOU ATTENDED THE ASA ADVANCED SCHOOL? ______              YEAR _______

ARE YOU IN THE MEDALS PROGRAM? _______      WHAT LEVEL? _____________________

ARE YOU IN THE NATIONAL INDICATOR FRATERNITY? _______________    YEAR? ______

ARE YOU AN ELITE UMPIRE? _______________    YEAR? ____________

PLEASE LIST YOUR GOALS FOR UMPIRING USA SOFTBALL______________________________

_____________________________________________________________________________

DO YOU WORK FOR ANY OTHER ASSOCIATIONS?  _____________________________

______________________________________________________________________

Are you interested in serving on a Committee or in a leadership position within USA Softball of North Carolina?  ___________________________________________________________

Are you interested in working any of the following State Championship Tournaments?  Check all that apply.

 

Fast Pitch:

___June 2-4, 2017                        Girls 16/18U            Qualifier, Eastern NC TBD

___June 9-11, 2017          Girls 10/12/14U     State Tournament: Locust, Greensboro, and Burlington

___June 16-18, 2017       Girls 16/18U            State Tournament: Burlington, Graham, and  TBD

___June 23-25, 2017       Girls 10/12/14U     Qualifier, Greensboro, Burlington and TBD

 

Slow Pitch:

___August 11 – 13, 2017             Men’s Church State Championship: Cary

___August 11 – 13, 2017                        Men’s Class E State Championship: Cary

___August 11 – 13, 2017                        Men’s Co-Ed Slow Pitch Championship: Cary

New for 2017:  All umpires working any level of an NC ASA/USA Softball NC game (league, recreation, tournament, men’s, women’s, co-ed, youth) must be background checked. 

Go to www.registerusasoftball.com   $11.  Allow 2-3 weeks for completion.

Do you have any suggestions for the UIC Staff moving forward to continue improving USA Softball of NC?  ____________________________________________________________

_________________________________________________________________________

Are there any future topics you would like further training in? ______________________

________________________________________________________________________

Name ________________________________________________________________________

Address_____________________________City________________State_______Zip_________

Social Security #____________________________ Birth Date ___________________________

Phone # (H) _________________________________(C) ________________________

Email Address ___________________________________________________________

SIGNATURE _________________________________________________________

Fees should be mailed with Sanction Form:

ASA / USA Softball of NC

c/o Amber DeWald

6021 Yeaton Glen Dr

Winston Salem, NC 27107