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Special Conditions - Comments - Requirements

READ THEN ERASE TO MAKE A CHANGE Please let us know if you would like to volunteer for some special assignments here: Are you only available for limited periods of time? Do you need other special accommodation? Are you working for Judges Credits? Give Us you IAC Number. Are you lacking prior experience in the job you selected?

First Name	Middle/Nickname	Last Name
Address Line 1	Address Line 2	City
State Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania RI South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming	ZipCode	AFGHANISTAN  ALBANIA  ALGERIA  AMERICAN SAMOA  ANDORRA  ANGOLA  ANGUILLA  ANTARCTICA  ANTIGUA AND BARBUDA  ARGENTINA  ARMENIA  ARUBA  AUSTRALIA  AUSTRIA  AZERBAIJAN  BAHAMAS  BAHRAIN  BANGLADESH  BARBADOS  BELARUS  BELGIUM  BELIZE  BENIN  BERMUDA  BHUTAN  BOLIVIA BOSNIA AND HERZEGOWINA  BOTSWANA  BOUVET ISLAND  BRAZIL  BRITISH INDIAN OCEAN TERRITORY  BRUNEI DARUSSALAM  BULGARIA  BURKINA FASO  BURUNDI  CAMBODIA  CAMEROON  CANADA  CAPE VERDE  CAYMAN ISLANDS  CENTRAL AFRICAN REPUBLIC  CHAD  CHILE  CHINA  CHRISTMAS ISLAND  COCOS (KEELING) ISLANDS  COLOMBIA  COMOROS  CONGO  COOK ISLANDS  COSTA RICA  COTE D'IVOIRE  CROATIA  CUBA  CYPRUS  CZECH REPUBLIC  DENMARK  DJIBOUTI  DOMINICA  DOMINICAN REPUBLIC  EAST TIMOR  ECUADOR  EGYPT  EL SALVADOR  EQUATORIAL GUINEA  ERITREA  ESTONIA  ETHIOPIA  FALKLAND ISLANDS (MALVINAS)  FAROE ISLANDS  FIJI  FINLAND  FRANCE  FRANCE, METROPOLITAN  FRENCH GUIANA  FRENCH POLYNESIA  FRENCH SOUTHERN TERRITORIES  GABON  GAMBIA  GEORGIA  GERMANY GHANA  GIBRALTAR  GREECE  GREENLAND  GRENADA  GUADELOUPE  GUAM  GUATEMALA  GUINEA  GUINEA-BISSAU  GUYANA  HAITI  HEARD AND MC DONALD ISLANDS  HONDURAS  HONG KONG  HUNGARY  ICELAND  INDIA  INDONESIA  IRAN (ISLAMIC REPUBLIC OF)  IRAQ  IRELAND  ISRAEL  ITALY  JAMAICA  JAPAN  JORDAN  KAZAKHSTAN  KENYA  KIRIBATI  KOREA  KUWAIT  KYRGYZSTAN  LATVIA  LEBANON LESOTHO  LIBERIA  LIBYAN ARAB JAMAHIRIYA  LIECHTENSTEIN  LITHUANIA  LUXEMBOURG  MACAU  MACEDONIA  MADAGASCAR  MALAWI  MALAYSIA  MALDIVES  MALI  MALTA  MARSHALL ISLANDS  MARTINIQUE  MAURITANIA  MAURITIUS  MAYOTTE  MEXICO  MOLDOVA, REPUBLIC OF  MONACO  MONGOLIA  MONTSERRAT  MOROCCO  MOZAMBIQUE  MYANMAR  NAMIBIA  NAURU  NEPAL  NETHERLANDS  NETHERLANDS ANTILLES  NEW CALEDONIA  NEW ZEALAND  NICARAGUA  NIGER  NIGERIA  NIUE  NORFOLK ISLAND  NORTHERN MARIANA ISLANDS  NORWAY  OMAN  PAKISTAN  PALAU  PANAMA  PAPUA NEW GUINEA  PARAGUAY  PERU  PHILIPPINES  PITCAIRN  POLAND  PORTUGAL  PUERTO RICO  QATAR  REUNION  ROMANIA  RUSSIAN FEDERATION  RWANDA  SAINT KITTS AND NEVIS  SAINT LUCIA  SAMOA  SAN MARINO  SAO TOME AND PRINCIPE  SAUDI ARABIA  SENEGAL  SEYCHELLES  SIERRA LEONE  SINGAPORE  SLOVAKIA (Slovak Republic)  SLOVENIA  SOLOMON ISLANDS  SOMALIA  SOUTH AFRICA  Spain  SRI LANKA ST. HELENA  ST. PIERRE AND MIQUELON  SUDAN  SURINAME  SWAZILAND  SWEDEN  SWITZERLAND  SYRIAN ARAB REPUBLIC  TAIWAN  TAJIKISTAN TANZANIA  THAILAND  TOGO  TOKELAU  TONGA  TRINIDAD AND TOBAGO  TUNISIA  TURKEY  TURKMENISTAN  TURKS AND CAICOS ISLANDS  TUVALU  UGANDA  UKRAINE  UNITED ARAB EMIRATES  United Kingdom  United States of America  URUGUAY  UZBEKISTAN  VANUATU  VATICAN CITY STATE  VENEZUELA  VIET NAM  VIRGIN ISLANDS (BRITISH)  VIRGIN ISLANDS (U.S.)  WALLIS AND FUTUNA ISLANDS  WESTERN SAHARA  YEMEN  YUGOSLAVIA  ZAIRE  ZAMBIA  ZIMBABWE
E-mail Address	IAC Chapter #	Cell / Contest Phone
Evening Phone	Nextel - Radio	Daytime Phone
EAA Number	IAC Number
Contest Judging Activity:  Non-Competing  Competing Judge	Judge Rank / Type: National Regional	US National Judges are selected through a different rules process.