Casper Youth Baseball

Last Name:First Name:  MI:

Address:City:State:Zip:

Home Phone:Work Phone: Cell Phone:Age: Gender:

Email Adress: Occupation/Place of Employment:

Experience

How many years have you umpired baseball (include all levels)?

Have you umpired for Casper Youth Baseball before (Yes or No)?

        If yes, list years: 

Please indicate the number of years you have umpired the following:

Little League or other 7 to 12 year-olds other than Casper Youth Baseball

American Legion or Senior Babe Ruth or other league with players of ages 16 to 18

Small college         Major college

Other / Explain

Please indicate any certification you have for umpiring baseball by putting the number of years certified:

National Association of Umpires (NAU) - National Baseball Congress, Hap Dumont

National Umpires Association (NUA) - Babe Ruth Baseball

American Legion

Other / Explain

Please list any special training you have had in baseball umpiring (include date and locations):

List the number of years you have officiated the following sports:

Other than umpiring, please list all experiences you have had with baseball (playing, managing, coaching, board of directors, etc.):

Check the Level(s) of Casper Youth Baseball are you interested in umpiring

Please list any specific days and/or times that you usually will not be able to umpire.  This is the space to list any conflicts you have.  Remember, games are usually Monday through Friday at 5:45PM and 8:00PM:

Please list any conflicts of interest you may have in CYB umpiring (i.e. a relative playing, you also coaching).  This is merely for scheduling purposes; you will not be denied umpiring privileges because of this:

Why are you applying to umpire for CYB?

List two non-relative references who will speak-out on your dependability and on your experience (if any) in baseball:

NamePhone Number

NamePhone Number

Date Form Completed by Applicant:

Print this application and fax or mail it to CYB.