| IROA Online Application | |
| Discipline: | Select the discipline for which you are applying. You must be nationally certified in your requested discipline. If you are applying for IROA Handgun certification, you can be nationally certified in either Handgun or IPSC Air. |
| 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, AOL, Yahoo or t-online.de email address. |
| Skype ID: | Your Skype ID. If provided, it may be used to conduct an online interview with you. |
| Shirt Size: | Select your shirt size. This is required for your IROA shirt. |
| Pants Size: | Select your pants waist size and length. This is required for your IROA 5.11 pants. |
| 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. |
| Current National Certification | |
| Stats Officer: | Check this box if you are a nationally certified stats officer. |
| Handgun: | Select your national certification for handgun. |
| Rifle: | Select your national certification for rifle. |
| Shotgun: | Select your national certification for shotgun. |
| IPSC Air: | Select your national certification for IPSC Air. |
| 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, AOL, Yahoo or t-online.de email address. |
| Strengths | |
| Please list three of your strengths as a Range Official. |
| 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. |