Peru State College
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Intramural Official / Score Keeper Interest Form

Phone Number:
Best Way to Contact: Email Call Text
Intramural Staff Interest: Official Score Keeper
Sport Interest:

Please check the following sports you are interested in being an official / score keeper for. Check all that apply.

Basketball Flag Football Floor Hockey
Indoor Volleyball Sand Volleyball Softball
Do you have work-study:

Workstudy is not required.

Yes No

Please list days and times you are available. Intramural sports are held Monday - Thursday evenings, generally from 6:00 - 10:00pm


e.g. Monday: 7:00 - 9:00

e.g. Tuesday: 6:00 - 7:00

Additional Questions or Comments:
Intramural Staff Confirmation

Peru State College Intramural Officials and Score Keepers are expected to have a thorough knowledge of the rules and regulations of intramural sports. For further questions or comments please contact Chelsea Allgood at 402.872.2252 or Jeremy Esry at 402.872.2441.


By typing your name and date in the boxes below you certify that the above information is correct to the best of your knowledge.

Date: e.g. 01-01-10

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