Last Name:
First Name:

Staff Assignment: Cheer Dance Tech Spotter Announcer General Event Trainer Other

Street Address:
City:
State:
Zip:

Home Phone:
Cell Phone:
Work Phone:

Email 1:
Email 2:

Mileage to competition location:

Conflicts:
(for performance judges only: Teams you have coached/performed with in the last 5 years; teams that include a relative/close friend; schools where you currently work, choreography, or any other conflict you feel is relevant)

Biography: