INFORMATION FORM
Yes, I want to officiate at the Milwaukee Winter Club for the 2017-2018 season.
Name
Father's Name
Mother's Name
Address
City
Zip
Your e-mail address
Parents e-mail address
Home Phone
(xxx-xxx-xxxx)
Officals Cell Phone
(xxx-xxx-xxxx)
Parents Cell Phone
(xxx-xxx-xxxx)
Age
12
13
14
15
16
17
18
Date of Birth
USA Hockey Level
Current Team
Level Officiated at Last Year
School you are attending