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 Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Mobile Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Membership *

New Current Expired
Expiration Date (required only if renewing):

Month Day Year
Past Referee History: Include Organization(s) and Level(s) (Note: Not required if renewing annual dues)
This fee is not required to submit initial application. You may select to pay annual due
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ACS Referee Annual Fee $ 35.00

Subtotal $ 0.00 Tax $ 0.00 Total $ 0.00
Upload your Completed Application
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