SGFOA Membership Application Form

South Georgia Football Officials Association Registration

New and returning members of SGFOA please fill out this form.
Name *

First Name Middle Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
E-mail *
example@example.com
Cell Number *
Home Number
Birthdate *

Month Day Year
Date
Social Security Number *
XXX-XX-XXXX
Drivers License Number *
Driver License Expiration Date *

Month Day Year
Date
Years Officiating *
Positions Worked *

Referee Umpire Line Judge Head Line Judge Side Judge Field Judge ECO First Year
Are there any schools you would have a conflict of interest with and cannot work? *
I understand that by checking this box I am an independent contractor and not an employee of SGFOA or GHSA *

Agree
I understand that by checking this box I am authorizing SGFOA to perform a background check as required by GHSA *

Agree
I understand that I am providing my personal information to enable SGFOA and GHSA to perform necessary background checks required by GHSA. By checking this box and signing below, I am acknowledging this understanding

Agree
E-Signature (Typed) *
Signature

Clear
Signature Date

Month Day Year
Date
Should be Empty:

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South Georgia Football Officials Association Registration