Greater Eastside Junior Football Association
Officials Registration Form
2008

Referee Coordinator:  Bob Goldberg                                      Phone: (425)454-7304
                                       12615 NE 6^th St.                                  Mobile: (206)255-7996
                                       Bellevue, WA   98005                        Email: lifsgr8@speakeasy.net

 Name: ___________________________________ 

 Address: _________________________________

                ___________________________________          ZIP _________________________

 Phone: _________________________ (Day)          __________________________ (Evening)

 Email: ____________________________________________

                                    Please cross out any dates (below) you are not available.

                                   Game Dates:       Aug 30
                                                                Sept.    6          13        20        27
                                                                Oct.      4          11        18        25
                                                                Nov.      1          8       

 Other officials with whom you would like to be crewed:

 ___________________________________________

____________________________________________

 Additional Conditions:  _______________________________________________________

 __________________________________________________________________________

 __________________________________________________________________________

 Please complete this form and return to Bob Goldberg via email or to the address above. 

We need your help in recruiting additional referees, if you know someone that you would like to work with, please copy this form for them and have them return it to Bob Goldberg.