What Position(s) would you like to apply for:

JUDGE TIMEKEEPER SCOREKEEPER STAGING REGISTRATION HOSTING

VENUE SET-UP

Are you at the Instructor Level Non-Instructor Level

Judging Preferences if Judging

  Beginners     Intermediate      Advanced     Adults     Children     Weapons

Are you applying to volunteer for  Standard Tournament     Sport Jujitsu & Grappling

                                                      Both Standard & Sport Jujitsu

What shift(s) can you work Morning Shift (6:00am - 12:00pm)  Afternoon Shift (12:00pm - 6:00pm)

  Both Shifts (6:00am - 6:00pm with Breaks)

Are you Competing No  Yes  What Divisions

First Name Last Name

Gender Male Female    Age: Junior (10-13)  Teen (14-17)  Adult (18 and up)

Shirt Size Men's Medium Men's Large Men's Extra Large

Mailing Address 1

Mailing Address 2

City State None Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachutes Michigan Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming   Zip

Phone Number  Work Number

Email 

Style Time in Years Rank

Style Category:   Hard     Soft     Grappling     Weapons     Other

Your Instructor's Name

Name of School/Dojo

I certify that the foregoing information is correct. I agree to abide by the principles of Great Western Nationals with regards to my conduct as a Judge. Any misleading or false statements contained within this application are grounds for removal from Judging/Timekeeper/Scorekeeper position and removal from the event.

Name of Applicant  Date (mmddyy)

Name of Parent/Guardian if applicant under 18

Please EMAIL this form by clicking on the SUBMIT  button below.