2015 MIDWAYUSA & NRA BIANCHI CUP 17-23 May 2015 Columbia, MO RANGE STAFF AVAILABILITY FORM Please fill out form completely. FIRST NAME: LAST NAME: ADDRESS: CITY: STATE: EVENING PHONE: ZIP: DAY PHONE: PHYSICIAN: PHONE: EMERGENCY CONTACT: PHONE: SHIRT SIZE: EMAIL: CERTIFICATIONS: NRA Certified Instructor NRA Certified Coach NRA Referee NRA Training Counselor NRA Chief Range Safety Officer Current EMT/First Responder NRA Classified Shooter NRA Range Safety Officer Other ________________________ NRA National Coach Development Staff CPR Other ________________________ SPECIAL SKILLS (Please list any special skills you have - photography, public relations, sales, etc…): CHAMPIONSHIP EXPERIENCE: (Please check one) I have never worked for a shooting competition or any NRA event before. I am a returning Staff Member; I have previously worked at the following NRA events: ASSIGNMENT REQUEST (20-23 May 2015): Range Staff Sales Photography Office Staff if available **NOTICE: Range Staff are scheduled to arrive 17 May for check-in, training and to begin work, and scheduled to depart 23 May 2015. Bianchi Staff & Interns Receive: • Valuable working knowledge and skills • A daily rate based on experience and longevity • Lunch Provided 19 – 23 May 2015 • Championship Staff Shirt • Invitation to all Social Events & Awards Ceremony (Awards Ceremony is Semi-Formal - REQUIRED) **Travel expenses are the responsibility of the Range Staff member. Confirmations and information packets will be mailed to you in February. Please direct all future questions regarding this championship to the NRA Pistol Department, Damien Orsinger, at 703-267-1478 or email: [email protected] APPLICANT SIGNATURE: I, _____________________________, certify that the above information is true to the best of my knowledge. _________________________________________ ___________________________ Signature of Applicant Date Mail completed application to: NRA Competitive Shooting Division, Attn: NRA Bianchi Cup, 11250 Waples Mill Road, Fairfax, VA 22030 Fax: 703-267-3941 Email: [email protected] Submit Now
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