Name: __________________________________
Address: _______________________________________________________________
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Phone: (_______) _______________ Cell (______) ___________________________
Email Address: __________________________________________________________
OBA Level: ____________ Citizenship: _____________________________________
Birthdate: ____________________________ Age: _________
Number of umpiring seasons: __________
What are your strengths in umpiring: _________________________________________
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What are some of the things you need to work on: _______________________________
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Are you able and willing to travel to the States to umpire tournaments: ______________
Do you have a car? ________ a valid driver’s licence? _________
Agreement: I hereby agree to all the terms required to be a member of the Canadian Blues. I will have enclosed $________ for the membership fee for the year ________.
I am aware that if my membership application is not accepted, that is the only time my membership fee will be refunded.
Please send this form and the membership fee to: Canadian Blues,Attention: John Luong, 3143 Church St., Fayetteville, NC, 28312.