Application for Membership
Date
Applicants
Name
.
Phone-Home
.
..
E-Mail
Address
.
.. Fax
...
Work
or Cell #
.
Address
(Include City, State, Zip Code)
Date
of Birth:
Marital Status:
Sex:
.. Weight:
.. Height:
.
...
Spouses
Name:
.
Presently
Employed at:
.
Have
you ever been rejected for membership in the CAOA or any other athletic
officials association?
.. If yes, explain on the reverse side
of this application.
Were
you ever a member of this association in previous years?
.. If yes, when did you first start?
.
I
hereby make application to officiate in the following sports: (Please check
the sports you are approved to work by the IHSAA and list the years of
experience in each.)
Football (
)..
.. Volleyball (
)
...
Baseball (
)
.
... Swimming (
)
...
Softball (
)
Track
& Field (
)
...
Wrestling (
)
Soccer (
)
...
Basketball (
)
Gymnastics (
)
...
How
long have you had your Indiana Card?
Please
list other states you have a valid officials license:
I
agree to the requirements that I take a written examination in the sport(s)
requested of me by the membership committee should they desire such.
A
fee of $25.00 (Checks payable to
I
certify that I am now in possession of an IHSAA card while making this
application.
.
(Signature)
Signature
of Sponsoring Member (Optional)
Mail to:
CAOA
Howard Gauger
1664 Stone Lake Drive
Laporte, IN. 46350
caoaofficials@yahoo.com or howardgauger@yahoo.com
Revised 9-10-2007