Please provide the following information as completely as possible:
Do not press "Enter" Key or click on "Submit Form" until complete.
Use your "TAB" key or mouse to move from one entry point to the next.
Enter your information and click on the "Submit Form" button when you are finished.

After you complete the form and click on "Submit Form", you will be returned to a Confirmation Page to ensure that your information was received.

USSF ID Number (required) 
 
 I wish to   Choose
Add my name to the list of attendees
Remove my name from the list of attendees
Alter my contact data

      Enter South Carolina Referee Information Below     

                First Name 
               Middle Name 
                 Last Name 
           Street Address1 
           Street Address2 
                      City 
                     State 
           Zip/Postal Code 
           Gender (M or F)  Male     Female
                Referee Grade      ChooseGrade 9Grade 8Grade 7Grade 6Grade 5Other 
Date of Birth (mm/dd/yyyy) 
                Cell Phone  Use this format:   999.999.9999
                Home Phone  Use this format:   999.999.9999
            E-mail Address 

Are you available to officiate on Friday?      Yes     No
Are you available to officiate on Saturday?  Yes     No
Are you available to officiate on Sunday?      Yes     No

Will you require a room for Friday night?      Yes     No
Will you require a room for Saturday night?    Yes     No

Do you need a Developmental Assessment if one can be arranged?    Yes     No
Do you need a Maintenance Assessment if one can be arranged?        Yes     No
Do you need an Upgrade Assessment if one can be arranged?              Yes     No

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