KALAMAZOO BOYS 18 & BOYS 16 NATIONAL CHAMPIONSHIP APPLICATION
Friday, August 7, 2009 to Sunday, August 16, 2009
Chief Umpire:   John Coleman              JBCPharmD @ aol.com   PH:  630.964.6334  CP:  630.697.9612	FAX:  630.434.1389
Deadline:  May 15, 2009:  *Required information		Mail to:  John Coleman; 7310 Ticonderoga Road Downers Grove, IL 60516	
	
*NAME:												

*ADDRESS:												

*CITY							*STATE	*ZIP				

*HOME PH			   B PH			   CELL PH			    No CELL 	    

*EMAIL ADDRESS:											

*USTA MEMBER NUMBER			 *MEMBER EXPIRATION DATE			

NON MIDWEST OFFICIAL:  PLEASE GIVE YOUR SECTION OR DISTRICT CHAIRMAN’S INFORMATION 

REFERENCE NAME______________________________   REFERENCE EMAIL__________________________________

*CURRENT CHAIR CERTIFICATION (select one)

Don’t know___	None___     Section Chair (SC)	USTA Chair (UC)___   National Chair (NC)___     Professional Chair (PC)___

*CURRENT LINE CERTIFICATION (select one)

Don’t know___	None___     Section Line (SE)	USTA Line (UL)___   National Line (NL)___     Professional Line (PL)___

*MY PREFERRED SHIRT SIZE 

W Small___	W Medium___	W Large___	
M Small___	M Medium___	M Large___	M X Large___	M XX Large	

*The days I am available to work: (first time Kalamazoo officials must be available to work on FRIDAY, Aug 7th, 7:30 AM).  Partial day availability should be minimized.  Check at most one box in each column.

	8/7	8/8	8/9	8/10	8/11	8/12	8/13	8/14	8/15	8/16	
	F	Sa	Su	M	Tu	W	Th	F	Sa	Su	
All Day											
AM Only										-----	
PM Only										-----	
I can work the Friday night 8/7/09 exhibition	 yes___ no___

*I need housing     yes_  _	no___	*Gender:  Male____ Female	    	One way mileage to Kalamazoo 		
*I am a smoker     yes___		no_  _	*I snore    yes	 no	 don’t know 	
Rooms at a hotel are not all comp rooms.  Please do not abuse the privilege of available housing.    

I need housing for the following nights.
Thurs	Fri	Sat	Sun	Mon	Tues	Wed	Thurs	Fri	Sat	
8/6	8/7	8/8	8/9	8/10	8/111	8/12	8/13	8/14	8/15	

I have no roommate preference ___   My preferred Roommate is:  																							  

I have local transportation yes___ no___

Photo ID
I will be on site on Thursday August 6, 2009 for the photo shoot ___             
I will send an ID photo in jpg format ___