IROA Online Application

This form will allow you to send your application to IROA electronically which will speed processing of your request. However, you must still print out a hard copy as well, and have it signed by your Regional Director and your NROI President.

Description of Fields

Fields whose titles are in bold are required. All others are optional.

Identification Information

First Name: Type in your first or given name.

Last Name: Type in your last or family name.

Date of Birth: Select the year, month and day of your date of birth.

Mailing Address 1: The address at which you reside. e.g. A street number and name, or the name of your house if a street address is not applicable.

Mailing Address 2: A second line for your mailing address, if applicable.

City: The city in which you reside.

State/Province: The state or province in which you reside, if applicable.

ZIP/Postal Code: Your ZIP or postal code, if applicable.

Country: The country in which you reside.

Phone: A phone number where you can be reached.

Email Address: Your email address. It is very important that this be accurately entered. The automated IROA system will send an email to this address if your application is accepted. Do not use a Compuserve or AOL email address.

Shirt Size: Select your shirt size. This is required for your IROA shirt.

Membership Information

Region: Select your IPSC membership Region.

Member Since: Select the year that you joined your IPSC Region.

Years Active as a Competitor: Enter the number of years that you have been actively competing in IPSC matches.

Years Active as an Official: Enter the number of years that you have been actively officiating in IPSC matches.

My Current National Certification is: Select the rank for which you are certified by your NROI.

Level I Range Officer Seminar

Year: Select the year in which you attended the IROA Level I Range Officer Seminar.

Location: Enter the name of the location where you attended the seminar.

Instructor: Enter the name of the instructor of the seminar.

Level III Match Experience

You must identify the most recent 5 Level III sanctioned matches that you have worked as an official.

Region Select the Region in which the match was held.

Year Select the year in which the match was held.

Month Select the month in which the match was held.

Role Select your role in the match.

Match Name and Location Enter the name of the match, and the location where it was held.

Other Qualifications

Enter any additional qualifications you may have. For example, if you have taken any Range Officer courses in other Regions.

IPSC References

You must provide a name and email address for 3 IPSC references.

Name Enter the name of the person.

Email Address Enter the email address of the person.
Do not use a Compuserve or AOL email address.

Additional Information

Are you available to travel to large International Matches? Select the Yes or No radio button.

Are you fluent enough in English to give the IPSC range commands and a complete stage briefing without difficulty? Select the Yes or No radio button.

What other languages do you speak? Enter any languages that you speak besides English.

Why do you want to join the IROA fellowship of International Officials? Tell us in your own words why you want to be an IROA official.

Identification Information
First Name:	Type in your first or given name.
Last Name:	Type in your last or family name.
Date of Birth:	Select the year, month and day of your date of birth.
Mailing Address 1:	The address at which you reside. e.g. A street number and name, or the name of your house if a street address is not applicable.
Mailing Address 2:	A second line for your mailing address, if applicable.
City:	The city in which you reside.
State/Province:	The state or province in which you reside, if applicable.
ZIP/Postal Code:	Your ZIP or postal code, if applicable.
Country:	The country in which you reside.
Phone:	A phone number where you can be reached.
Email Address:	Your email address. It is very important that this be accurately entered. The automated IROA system will send an email to this address if your application is accepted. Do not use a Compuserve or AOL email address.
Shirt Size:	Select your shirt size. This is required for your IROA shirt.

Membership Information
Region:	Select your IPSC membership Region.
Member Since:	Select the year that you joined your IPSC Region.
Years Active as a Competitor:	Enter the number of years that you have been actively competing in IPSC matches.
Years Active as an Official:	Enter the number of years that you have been actively officiating in IPSC matches.
My Current National Certification is:	Select the rank for which you are certified by your NROI.

Level I Range Officer Seminar
Year:	Select the year in which you attended the IROA Level I Range Officer Seminar.
Location:	Enter the name of the location where you attended the seminar.
Instructor:	Enter the name of the instructor of the seminar.

Level III Match Experience
You must identify the most recent 5 Level III sanctioned matches that you have worked as an official.
Region	Select the Region in which the match was held.
Year	Select the year in which the match was held.
Month	Select the month in which the match was held.
Role	Select your role in the match.
Match Name and Location	Enter the name of the match, and the location where it was held.

Other Qualifications
Enter any additional qualifications you may have. For example, if you have taken any Range Officer courses in other Regions.

IPSC References
You must provide a name and email address for 3 IPSC references.
Name	Enter the name of the person.
Email Address	Enter the email address of the person. Do not use a Compuserve or AOL email address.

Additional Information
Are you available to travel to large International Matches?	Select the Yes or No radio button.
Are you fluent enough in English to give the IPSC range commands and a complete stage briefing without difficulty?	Select the Yes or No radio button.
What other languages do you speak?	Enter any languages that you speak besides English.
Why do you want to join the IROA fellowship of International Officials?	Tell us in your own words why you want to be an IROA official.