Clinic Registration – West – El Paso

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Fields marked with a * are required

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Email *

Phone 1 *

Type

Phone 2

Type

Name

Phone

Years Experience - High School *

Years Experience - Collegiate

Do you belong to a rules study group?

Rules Study Association/Location

Conference / Board 1

Conference / Board 2

Conference / Board 3

Note:
Currently, we have openings at R and U. When making on-field assignments, the TBFOC may interchange positions such as HL/LJ and SJ/FJ/BJ.

Position Preference 1

Position Preference 2

Position Preference 3

Shirt Size *

Comments

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