RefereeVerified Trainee ApplicationPlease complete the referee trainee application below.Member Name(Required) First Last Email(Required) Mobile Phone(Required)Primary Address(Required) City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State or Province Do you have a secondary residence(Required) No YesSecondary Address(Required) City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State or Province Membership ID(Required)Membership Expiration Date(Required) MM slash DD slash YYYY Membership Type(Required) Challenger ChampionCasual memberships are not valid for referee program.Do you have a trainer?(Required) Yes No SelfName of Trainer(Required)Please select the region associated with the state of your primary residence. *(Required) Atlantic (CT,MA,ME,NH,RI,VT) Atlantic South (AL,FL,GA,MS,PR,VI) Great Lakes (N,MI,OH) Great Plains (CO,KS,MT,ND,NE,SD,WY) Mid-Atlantic (DC,KY,MD,NC,SC,TN,VA) Mid-South (AR,LA,OK,TX) Middle States (IA,IL,MN,MO,WI) Mountain (NV,UT) North Mid (Atlantic-DE,NJ,NY,PA,WV) Pacific Northwest (AK,ID,OR,WA) Southwest (AZ,NM) West (CA,GU,HI,NMI) Canada Europe (EPF) OtherAre you willing to travel for training and attend training calls in the evenings or on weekends?(Required) Yes No MaybeDescribe your officiating experience?(Required)What is your ultimate goal of becoming a USAP Official?(Required)Any other details you would like us to know about you?Please read and agree to the following agreement:(Required)You have been granted access to USA Pickleball (“USAP”) confidential copyright protected material as part of the USAP Officiating program. You understand that by accepting USAP Officiating designation and or credentials that you will not distribute or otherwise use copyright protected information outside of USAP events and training without written approval from USAP’s Director of Officiating. This includes public distribution such as videos, social media posts and printing for non-personal use. By accepting the position of Verified Trainee, Level 1 Referee, Level 2 Referee, Certified Referee or any credentialed level of official, you agree to abide by the Code of Conduct found in the USAP Pickleball Referee Handbook. USAP has a zero tolerance on gambling or betting on Pickleball related activities. Failure to comply may result in the termination of your participation in the USAP Officiating program, removal of any credentials, and / or possible legal action. You also consent to a background check if necessary from USAP to confirm information needed by SafeSport. This is a required program by USAP. I agree to the USA Pickleball Officiating PolicySign Your Name(Required)
