2014 Show Me Reply Form
Name
*
First
Last
Cell Phone Number
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Address
*
Home/Alternate Phone Number
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City
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State
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Zip Code
*
Email
*
Polo Shirt size (men's size)
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Small
Medium
Large
X Large
XXL
3 X
T-Shirt size (men's size)
*
Small
Medium
Large
X Large
XXL
3 X
I'm working one or both weekends and I need a hotel room on:
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FR night Apr 4
SA night Apr 5
SU night Apr 6
TH night Apr 10
FR night Apr 11
SA night Apr 12
I'm working both weekends and would like help in finding a place to stay on the following nights between the 2 sessions:
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MO night Apr 7
TU night Apr 8
WE night Apr 9
SU night Apr 13
Roommate preference (1st session)
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DATE and TIME I WILL ARRIVE (1st session):
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DATE and TIME I WILL LEAVE (1st session):
*
Roommate preference (2nd session):
*
DATE and TIME I WILL ARRIVE (2nd session):
*
DATE and TIME I WILL LEAVE (2nd session):
*
Tell me the date and the clinician for the USAV referee clinic you attended in your region this season:
Date of clinic
*
Name of clinician
*
Comment
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