NIRSA Championship Series

NIRSA Regional Championship Staff Interest Form

NIRSA Regional Flag Football Championships staff deadline: September 1, 2014

* denotes required field

Director Positions (rank according to preference): *

Director of Competition

Director of Officials

Committee Positions: *

All-Tournament Committee

Officials Committee

Officials Sub-Committee

Operations Committee

Regional Site Interest (select all that apply): *

Arizona State University

Ohio State

Oklahoma State University

Springfield College

Texas A&M University


University of Florida

University of Maryland

University of Nebraska

University of Notre Dame

University of Southern Mississippi

Western Kentucky University

Personal Information

* Name

* Institution

* Title

* Email

* Phone

* T-Shirt Size

* Current NIRSA Region

* Years in Campus Rec

* Membership Status

Event Experience

Please describe in detail why you would like to be part of this tournament:

List all NIRSA Championship Serries events worked (position, specify National or Regional, tournament site, year)

Other tournament experience (National, Regional, state, other):

Further explanation (if needed):

Please define what developing student officials means to you? (In 250 words or less)

If applying for the Director of Officials or for an official’s committee, please answer the following questions:

Are you a current, active sports official?

Yes No - Total # of years officiated:

What sports?
(BB and FFBall only)

Briefly describe your officiating experience in the following areas:
(BB and FFBall only)

Other applicable officiating experience:

  Please note: completion of this form does not guarantee placement on a committee.

NOTE: After submitting your form, you will receive an email confirmation from the NNC within 7 business days. If confirmation is not received, please contact


NIRSA Headquarters: 4185 SW Research Way, Corvallis, Oregon 97333-1067
tel: 541-766-8211 • fax: 541-766-8284 • email: