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2010

Wisconsin Umpires Association

SECOND YEAR TRAINING

REGISTRATION FORM

(Please print clearly all the information requested below.)

 

NAME ________________________________________________________________

 

ADDRESS ________________________________________________________________

 

CITY ____________________________ ST._______ ZIP _____________

 

HOME PHONE # ___________________WORK # ________________________

 

CELL#___________________EMAIL ADDRESS___________________________

 

 

WUA Member Since: (What year did you join?)___________

 

Years umpiring ________Are you WIAA Certified ______What level_________

 

What sports do you umpire? (Please prioritize, #1 would be the sport you do the most, then 2 & 3)

Baseball_____               Girls Fast pitch________                 Slow Pitch softball_____

 

 

INSTRUCTIONS:  Mail this form with your check made payable to THE WUA FOR $60.00. DO NOT SEND CASH! Mail check to: Al Hochmuth, Treasurer at W161 N10998 Meadow Drive, Germantown, WI. 53022.

 If you have any questions contact Al at 262-250-1525. Thank you.

 

 

 

Below is your receipt:

 

 

(MEMBERS RECEIPT)-------------------------(CUTHERE)------------------------------------------------

2010 SECOND YEAR LEVEL TRAINING FEES

                                                         

Date Payment Sent_____________ Amount $ ________Check # __________

 

AL HOCHMUTH, WUA Treasurer______________________________________________

©2010 WUA