SGFOA Membership Application Form

South Georgia Football Officials Association Registration

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

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
E-mail
example@example.com
Cell Number
Format: (000) 000-0000.
Home Number
Format: (000) 000-0000.
Birthdate

MonthDayYear
Date
Social Security Number
XXX-XX-XXXX
Drivers License Number
Driver License Expiration Date

MonthDayYear
Date
Years Officiating
Positions Worked
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
I understand that by checking this box I am authorizing SGFOA to perform a background check as required by GHSA
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
E-Signature (Typed)
Signature
Signature Date

MonthDayYear
Date
Should be Empty:

South Georgia Football Officials Association Registration