Here - Area 10/A

REFEREE
UPGRADE CLINICS 2015
Presented by Area 10A
Courses: Intermediate and Advanced
When:
Time:
Friday, May 15 and Saturday May 16
Friday 5:30 pm - 9:30 pm
Saturday 8 am – 5:00 pm
Both days are mandatory in order to get full course credit
LOCATION: Cal State Bakersfield University, Science Building 3
9001 Stockdale Hwy., Bakersfield, CA. 93311-1022
E-Mail Applications no later than May 8, 2015.
For further information call Brett Price (661) 477-6100 or e-mail: [email protected]
Let your Referee Administrator know and use EAYSO and e-mail a
registration to Brett. If you have no computer please ask your Referee
Administrator or other volunteer to help you getting registered. Registering
on EAYSO is important so your information will be entered correctly and we
will print the course roster of the clinic from e-AYSO for check-in. Sending
an e-mail to Brett will help us verify rosters and your contact information.
This form is for candidates which have no access to RRA and a computer
and as last resort will mail this form with check for full amount.
---------------------------------------------------------------------------------------------------------------------------Indicate [X] the clinic you will attend (only one) and PRINT CLEARLY all information.
Intermediate____ ($60)
Advanced____ ($60)
Name:
Address:
City:
State:
Zip Code:
E-Mail:
Phone number where to contact you
Current Badge Level
None[ ] INTERM. [ ] ADV [ ]
Region Name
Home [ ] Work [ ]
Region Number
When you register we will prepare an invoice to give to your Region or pay cash at door.
Candidates from within Area 10A, send no money, your region will be billed directly.
No refunds after May 8, 2015 unless the course is cancelled.