Officials Application

Our application process for the 2019 Kansas Shrine Bowl has ended. By completing the following application you are indicating your interest to officiate in the 2020 Kansas Shrine Bowl in Topeka. Thank you.

Kansas shrine bowl application to officiate

* Indicates required field

Name *

First

Last

DOB *

Address *

Email *

City *

Phone (Work) *

State *

Phone (Cell) *

Zip *

Number of Years Officiating Football *

Masonic Membership (if any) *

Are you actively officiating? *

Shirt Size *

Year's during which I have officiated *

Rules or Training Meetings attended & approximate date

Training *

Date *

Training *

Date *

Training *

Date *

Training *

Date *

Regional, State or National Play-off games officiated

Event *

Date *

Event *

Date *

Event *

Date *

Event *

Date *

Event *

Date *

Indicate any past Kansas Shrine Bowl experiences *

Past Official Past Player Past Camp Staff Past Board Member

References (Coaches)

Name *

Email *

Name *

Email *

References (Officials)

Name *

Email *

Name *

Email *

Head Linesman *

Line Judge *

Side Judge *

Coordinator *

Please number the following positions 1 through 8, starting with your most qualified position as #1

Field Judge *

Back Judge *

Referee *

Umpire *

Comment *

Submit