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2. First Name*
3. Last Name*
5. Email Address*
6. Main Phone*
8. Position

   What type of position are you applying for?

   1. Baseball/Softball Official
   2. Soccer Official
9. Type of Experience*

   Indicate the type of experience you have. Select any and all that apply

   1. Scorekeeper
   2. Official
   3. Coach
   4. Player
   5. None
10. Years of Experience*
    How many years of experience do you have in any of the categories you checked?
12. Certifications
    Do you now or have you ever held a certification for referring, officiating, or umpiring any sport? If so, please describe it here.
14. NOTICES
    1. This is a contract position that is paid per game. It is not considered full or part time employment. 2. VLPRA runs initial and annual criminal history checks on all officials using the NRPA criminal screening standard. If you are selected to officiate for VLPRA, you must pass this initial screening and annually pass to continue officiating. 3. To officiate for VLPRA, you will be required to attend occasional paid trainings. 4. VLPRA officials will be expected to wear officiating attire. Acceptable attire colors may change between sports/seasons. 5. Officials will be paid for games officiated and trainings attended on the biweekly pay schedule for VLPRA employees and contractors.
16. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
18. Electronic Signature
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field