NEW MEMBER  REGISTRATION

 

Texas Association of Sports Officials

 

Circle the sport you are interested in officiating

 

Baseball     Basketball    Football    Soccer   Softball    Volleyball

PLEASE PRINT CLEARLY

 

Date:  _______________

 

Chapter Name: ______________                 Chapter Code: ___-___-___

 

Social Security #:   ______ - ______ - _______

 

Telephone #’s:  Work ____________________Home                         

 

Cell                        Cell Provider                      Fax                      

 

Date of Birth: ____________       e-mail:                                                

 

Name:                                                                                        

 

Mailing Address:                                                                              

 

City                                                   , TX,   Zip Code___________

 

I certify that I have not been arrested for or convicted of a felony criminal offense under the laws of any state or the Federal Government.  I understand the penalty for falsification is expulsion from the Texas Association of Sports Officials. 

_____________________________    _________________

Signature                                                                                                    Date