All Star Football Officials Registration Form 2024

All Star Football Officials Registration Form 2024
Personal Information
Official's Name*

First NameLast Name
Spouse Name

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Number*

Area CodePhone Number
Home Number

Area CodePhone Number
Work Number

Area CodePhone Number
Birth Date*

MonthDayYear
Full Social Security Number*
Ex: 555-55-5555
Driver's License Number*
Driver's License Expiration Date*

MonthDayYear
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone

Area CodePhone Number
Officiating Information
Were you a member with ASFOA last year?*
Years with ASFOA*
Years with GHSA*
Position you prefer to work*

No ChoiceElectric Clock OperatorRefereeUmpireHead LinesmanLine JudgeSide JudgeField Judge
Shirt Size*
Are you on a crew?*
Name of the Referee
Are there any schools you should not work?
Are there any officials that you should not work with?
Independent Contractor Verification*

I understand that by checking this box I am an independent contractor and not an employee of the ASFOA, GHSA, GISA or GICAA.
Background Check Authorization*

I authorize ASFOA to perform a background check as required by GHSA.
Terms of Use*

I understand that I am providing my personal information to enable GHSA and ASFOA to perform necessary background checks required by GHSA. By checking this box and signing below, I am acknowledging this understanding.
GHSA Registration will be through Dragonfly Max - information will follow.
How would you like to pay?

PayPal (If you choose this option, please select the payment below and complete your payment on PayPal)Check (If you choose this option please DO NOT select PayPal and submit your payment via check. You MUST still submit this form by clicking the submit button at the bottom.)
Electronic Signature (Printed)*
Electronic Signature*

Clear
Please select your options to pay:
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2024 ASFOA DUES $70.00

Total $0.00
Should be Empty:

All Star Football Officials Registration Form 2024

Personal Information

Emergency Contact Information

Officiating Information