Application for Membership

Enrollment will not be permitted or renewed for anyone:

1. Convicted, or adjudicated with a finding of fault, guilt, or violation, in regard to an offense against a minor or any sexual offense unless/until such offense has been reversed by proper authority with jurisdiction over the matter; or
2. Convicted, or adjudicated with a finding of fault, guilt, or violation, in regard to an offense involving any illegal/illicit drug or controlled substance as prescribed by federal or state law or regulation

Please complete and submit the form below. Someone will be in touch with you regarding the next steps required to become a certified NH Track Official.

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First Name *

Last Name *

Alternate experiences in

Home Address *

Address Line 1

Address Line 2

City

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Zip Code

Work Address

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Preferred Mailing Address *

• Home
• Work

Preferred Email *

Email

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Alternate Email

Preferred Phone

Alternate Phone

What current certifications do you hold for sports officiating?

What sports officiating clinics have you attended in the last two years?

List your officiating experiences with Track & Field in the last two years?

Check the events that you have experience with. *

• Starter
• Clerk
• Finish Line
• Umpire/Exchange Zone Judge
• Track Referee
• Field Referee
• Shot Put
• Discus
• Javelin
• Long Jump
• Triple Jump
• High Jump
• Pole Vault
• Cross Country
• None, but I am willing to learn
• I have limited experience but I am eager to learn

List any special skills, interest, or experience you have in Track & Field and/or Cross Country.

Is there anything else you would like us to know about you?

Submit