Referee Application Form

Referee Application
MEMBERSHIP BENEFITS:

√ Sanctioned Player Membership to ACS – directly supports the growth and future of cue sports.
√ Annual Referee Membership package to include certificate, patch, luggage tag, rulebook, pool pen and membership card.
√ Eligibility to compete in the ACS Nationals Championships (8-Ball & 9- Ball Singles only if not an ACS league member).
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Mobile Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Membership*

NewCurrentExpired
Past Referee History: Include Organization(s) and Level(s) (Note: Not required if renewing annual dues)
Date

MonthDayYear
This should be date you are registering
ONLINE PAYMENT
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Referee Annual Fee$40.00
Referee Annual Fee (40 USD for each year). Annual Membership runs from January - December 31st. If you received an invoice, with a different amount other than $40.00, please call Stacey at 210-326-8908 to make your payment.

Subtotal $0.00Tax $0.00Total $0.00
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