APPROBATION OF NWBA GAME OFFICIALS

This form is used to approbate NWBA game officials for NWBA league games, exhibition games and
tournament play. Requirements for approbation are as follows:

1. Person applying for approbation needs to have completed and passed the written NWBA exam.
2. Must be sanctioned by local or state basketball officiating organization.
3. Must work with two (2) approbated officials.
4. Applicant must have recommendation signature of two (2) officials and coaches on form.

The following must be followed for the signature process:

1. Please fill out all necessary information
2. You must receive signatures from 2 approbated officials and coaches
3. This form must be sent to your conference president or commissioner for a signature
4. The final signature must be received the President of the NWBOA, Bill Kuerzi at
Kuerzi@hotmail.com and NWBA Program Director, Sherrice Fox at sherricefox@nwba.org.





















NWBA Approbation of Game Officials Form

Date:
Name of Applicant (First,Last, MI):
Home Address:
City, State:
Zip Code:
Phone Number:
Email Address:

1. Are you an accredited basketball official?:
2. How many years of experience do you have officiating able body basketball?: ___ Wheelchair
basketball?: ___

Please list the names of any league(s), conference(s), and/or association(s) in which you are
accredited and their location:




Please answer the following questions by writing yes or no.

1. Have you observed official wheelchair basketball games?
2. Have you studied the NWBA Rules and Case book?
3. Have you officiated wheelchair basketball games with an accredited official?
a. If yes how many? 1-5___ 6-10___ 11-15___ 16-20___ 21+___
4. Have you officiated wheelchair basketball games under the supervision of accredited officials?
a. If yes how many? 1-5___ 6-10___ 11-15___ 16-20___ 21+___

Please list any comments you have on the above questions:




Have you taken the rules exam and passed for the current season? Yes___ or No ___

Please list information for the person(s) that are recommending you for approbation. It is mandatory
that you have 2 officials and 2 coaches recommend you for approbation.

Name of Official:
Place of Observation:
Signature: Date:

Name of Official:
Place of Observation:
Signature: Date:


Name of Coach:
Place of Observation:
Signature: Date:

Name of Coach:
Place of Observation:
Signature: Date:


Statement of recommendation (to be made by supporting conference):







Approved by: _________________________________ _____________
Conference Name Date

_________________________________ ____________________________
Conference Commissioner Name Conference Commissioner Signature



Please do not write below this line. For NWBOA President use only.



Approved: ______ Denied: ______ Pending: ______


NWBOA President: ________________________ _________________________ ______
Printed Name Signature Date