SOUTHEASTERN ATHLETIC OFFICIALS ASSOCIATION

MEMBERSHIP APPLICATION

Residence Address:  _______________________________ City:  _____________  Zip:  ________

Business Address:    _______________________________ City:  _____________  Zip:  ________

Home Phone:  __________________  Business Phone: _____________________  Ext.:  _______

E-mail Address: _______________________________________ SS#________________

Please indicate with a check what sports you are interested in officiating:

Baseball    _______     Basketball  _______    Football    _______    Soccer  _______
Softball      _______     Volleyball   _______    Wrestling  _______        

For football, please indicate your position preference by numerical priority, 1-5:
Referee  ______  Umpire  _______  Linesman  ______  Line Judge  _______  Back Judge  _______

PERSONAL SPORTS HISTORY & REFERENCES

Name: ______________________________ Address:  _________________________

City / State:  ________________________ Zip:  _______ Phone:  ______________

Name: ______________________________ Address:  _________________________

City / State:  ________________________ Zip:  _______ Phone:  ______________

Last Booking Agent / Officials Association for who you officiated:

Name: ______________________________ Address:  _________________________

City / State:  ________________________ Zip:  _______ Phone:  ______________

Have you ever been convicted of a felony?    Yes _____     No _____

INSTRUCTIONS AND INFORMATION

1. Type or print legibly requested information. Be specific furnishing accurate information.
   
2. A check of $10.00 for Annual Membership Fee, July 1 through June 30, must accompany application. Following the required Constitutional investigation and Board approval, you will be notified in writing of the action taken regarding your application. Your check will be returned in the event of unfavorable consideration for membership.
   
3. All applicants will be required to satisfactorily pass both written and practical examination in each sport (in season) which they desire to officiate prior to receiving assignments for pay. The practical examination(s) in most cases will be administered under game or game like conditions.
   
4. Completely fill in the number of years experience you have had as a player, as an official, and as a coach for each of the applicable boxes for each of the listed sports you desire to officiate.

Confirmation with all the requirements of the Membership Application will expedite the processing of your application. An incomplete Application will be returned without action taken by the Board of Directors.

I, the undersigned applicant, have been satisfactorily briefed concerning the operation of the Southeastern Athletic Officials Association, its Constitution, Policies, and Procedures. If accepted into membership, I pledge my full support and cooperation to the Association and its Objectives.

Signed:____________________________________   Date:________________