WNCOA Application

WNCOA Registration 2008-2009

* I am registering for the following sport(s); deadlines and fees are after each sport:

baseball - December 1 - $60

basketball - September 1 - $60

football - July 1 - $60

soccer(fall) - July 1 - $50

soccer(spring) - December 1 - $50

softball - December 1 - $57

volleyball - July 1 - $60

wrestling - September 1 - $55

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

home phone number

work phone number

cell phone number

Email Address

* birth date (xx-xx-xxxx)

emergency contact name and number (during game hours)

* WNCOA experience (# of years)

other experience (# years)

if other association, where

* I will be leaving for a game from the following zip code

Explain below any involvement and/or connection with any school we serve (also may use for any other information you feel important):

* Have you ever been convicted of a felony?

Yes

No

First year WNCOA officials must give three references and contact information, including a former coach, school personnel or booking agent.

After you submit this form, you have ten (10) days to mail your registration fee(s) to the following address:

Eddy Taylor
WNCOA Secretary/Treasurer
170 Jonestown Rd
Asheville NC 28804

Make check or money order payable to WNCOA and note which sport(s) you are paying the fee(s) for.

* Indicates Response Required


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