Western Suffolk Baseball Umpires Association - (Suffolk County, NY)

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WSBUA 2026 New Candidate Registration Form-Umpire Class

* First Name:

* Last Name:

* Address:

* Town:

* Zip Code:

* Business Phone:

* Home Phone:

* Cell Phone:

* E-mail Address - Must have one.:

* Which school district do you reside in?:

Referred to WSBUA by (type in First and Last name of the WSBUA member who referred you):

* Shirt Size:

Answer all that pertain below::

Can work games during the week (M-F) @ 4pm

Cannot work (M-F) 4pm

Interested in working in the evening 6pm and Recreational Leagues

* Do you have Baseball Umpiring Experience?:

If "YES", which Organization:

* Do you have experience officiating other sports?:

If "YES", which Sport (select sport with most experience):

Any questions or comments?:

* Falsification of any parts of this application is grounds for expulsion from this assoc., regardless of reasons. I attest that the information given is correct to the best of my knowledge and affix my signature, in testimony there of.:

Paid ______ Ck.# ______ RB _____ CB _____ Manual_____

Written Test ______ Field Test ______

* indicates required fields