SDFVOA Application for Officials

• Application Date:

    -- mm/dd/yyyy
  

• Please provide the following contact information:
  (Items in BOLD are required items)

  First Name
  Last Name
  Middle Initial
  Street Address
  Address (cont.)
  City
  State/Province
  Zip/Postal Code
  Country
  Work Phone
  Home Phone
  Cell Phone
  E-mail
  ID Number
  ID State
  SSN:	123456789 (no dashes)
  	List any officiating camps you attended over the off-season (summer):
  	Have you been promoted to other college conferences, and if so, which ones?
  Due to SDFVOA obligation to the CIF, HSSOC and schools it provides / assigns officials to for games with school-age minors, we are required to ask the following: have you ever been convicted of any felony involving Sexual Acts or Violence of any kind on any person(s), adult(s) or minor(s)?
  YesNo
  You further agree that should you, while working as a member of the SDFVOA (during or off-season) be convicted of any of the above acts, you will immediately notify the SDFVOA Secretary / Treasurer in writing before officiating any SDFVOA games.
  Should you feel threatened in any way (physically or verbally) at any school or game site, you agree that you will immediately notify your assignor or SDFVOA President in writing.
  I understand and agree the San Diego County Volleyball Officials' Association is a non-profit corporation, whose sole and only purpose is the education / training and assigning of volleyball officials and other associated and ancillary duties that go along with the volleyball profession. I further understand and agree that as a SDFVOA Official I am an INDEPENDENT CONTRACTOR, and will be solely responsible for any and all State, Federal, Social Security and Disability taxes, Medical and Liability insurance and any other Local, State and Federal Fees and Taxes. I further agree that it is my sole responsibility to purchase, at my sole expense, any and all personal, medical and professional liability insurance covering myself to and from games and while officiating. I understand and agree that the SDFVOA's sole purpose is training, education and certification as stated by and in the SDFVOA By-Laws and the HSSOC, which the SDFVOA is governed by. I understand and acknowledge that I am not an employee of nor employed by the SDFVOA in any way, and there is no verbal or written agreement to the contrary. Anything to the contrary regarding my status as an Independent Contractor must be in writing signed by me (member) and the SDFVOA President and Secretary / Treasurer.
  Current 2007 - 2008 SDFVOA membership fees are: $75.00 for the year or $xx.xx for a season (i.e. boys or girls). To maintain your membership without officiating or training / classes, dues are $10 per year, which will maintain your status as a non-officiating member of the SDFVOA. I further agree to abide by all the Rules and By-Laws of the SDFVOA, CIF and HSSOC (a copy of the SDFVOA By-Laws is available to all members for the asking). I fully understand and agree to all of the above stipulations and that all information provided by me is current and accurate. I also understand that a copy of the SDFVOA (confidential) Roster containing name, physical and e-mail addresses, phone numbers and Social Security Numbers will be made available to all schools which the SDFVOA services as outlined by the CIF and HSSOC.
  Note: Turn back assignments - first turn back is free if turned back within 72 hours of it being made available or given to you via the assigning software. Thereafter, all other "turn backs" (i.e. 2,3,4 etc) will be assessed $20 per turn back, and is due and payable within four days of being notified by your assignor. Should you not pay, all other assignments can be taken away and reassigned until the turn back fee is paid. I fully and totally understand the above stipulations and by SUBMITTING this application, agree that the information provided by me is correct.
  NO ONE CAN WORK ANY SDFVOA GAMES WITHOUT COMPLETING AND SUBMITTING THIS APPLICATION!
  Full Name:           Signed Electronically:   Date:   Should you have any questions regarding the application or the above stipulations, please contact the SDFVOA Secretary / Treasurer, Paula Davila.
  ________________________________________________________________________________________Signature of Applicant
  (form will be signed in person at the first VB Officials meeting)

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