Questions regarding this application should be directed to officials@ctswim.org.

March 2-5, 2023, at Regional YMCA, Youth Development Aquatic Center, Brookfield, CT

Contact Information

First Name:*

Last Name:*

Email:*

Phone:

Select the gender of your athlete(s) competing in the meet:* Female Male Both None

Club and Certification

CT Club Code: AJSC ARAC BSPL BSY BULL CAC CAT CDOG CPAC FA FFLY FINS FVYT GLAS GRIT GRYM GWYB GYWD HALE HHAC IVY LEHY LST MAC MJCC NCA NCY NFAF NMEG NSC NWYL OAK ORCA OXO PAC PSC PSDY RAC RAYS RST RYWC SAQ SEAL SJCC SSAC SWAT SYS TAC UN VSYM WAC WEST WFYD WHAT WHSC WOLF WRAT WRTS WWRX WYW YCST ZEUS

Your LSC highest level of certification:* Administrative Official Stroke & Turn Chief Judge Starter Deck Referee Administrative Referee Meet Referee

Do you have previous championship meet experience?* Yes No

Do you still need one (1) Championship Meet (Regionals, Age Group, or Seniors) work session for CT Officials re-certification?* Yes No Not Sure

If applicable, please list your USA Swimming national certifications:

Select sessions you are available to work:

Morning Preliminary Sessions:

Friday

Saturday

Sunday

Evening Final Sessions:

Thursday

Friday

Saturday

Sunday

Comments/Questions:

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