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*
Home Number
Birthdate *

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

MonthDayYear
Date
Years Officiating*
Positions Worked*

RefereeUmpireLine JudgeHead Line JudgeSide JudgeField JudgeECOFirst 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

MonthDayYear
Date
Should be Empty:

South Georgia Football Officials Association Registration