INFORMATION FORM


Yes, I want to officiate at the Milwaukee Winter Club for the 2019-2020 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                Date of Birth     
USA Hockey Level  
Current Team
Level Officiated at Last Year  
School you are attending