Please fill out a separate form for each day that you work. Referees will only be paid if they submit a time sheet each day. Please submit a time sheet no later than the Tuesday after each weekend that you work.

Name Of Referee:
Address:
Town, State & Zip:
Phone:
E-Mail Address:

Please Check The Day That This Work Is For:

April 30	May 7	May 14	May 21
May 1	May 8	May 15	May 22	June 5	June 12

Please Check All Sessions That You Worked For The Above Day:

Bryn Mawr Polo Field 1:00 2:00 3:00 4:00 5:00 6:00 7:00

Welsh Valley Middle School 1:00 2:00 3:00 4:00 5:00 6:00