INFORMATION FORM
Yes, I want to officiate at the Milwaukee Winter Club for the 2009-2010 season.
Name
Address
City
Zip
Home Phone
(xxx-xxx-xxxx)
Parents Cell Phone
(xxx-xxx-xxxx)
Age
12
13
14
15
16
17
18
Other
Date of Birth
Level Officiated at Last Year
School you are attending
Your e-mail address
Parents e-mail address