DECATUR AREA OFFICIALS ASSOCIATION

NEW MEMBER FORM

Please complete this form and include a $10.00 check payable to DAOA for the first year of dues.

 

Name: _____________________________________________________________  

 

Address: ___________________________________________________________

 

City & Zip Code: _____________________________________________________

 

Home Phone: ________________________________________________________

 

Work Phone: ________________________________________________________

 

Cell Phone: _________________________________________________________

 

E-mail Address: ______________________________________________________

 

IHSA Officials ID: __________ (You may not have this yet, please contact us when received)

Please Check the Sports You Officiate and the Level You Are:

Baseball          X-Registered____     R-Recognized____     C-Certified____

Basketball      X-Registered____     R-Recognized____     C-Certified____

Football           X-Registered____     R-Recognized____     C-Certified____

Softball           X-Registered____     R-Recognized____     C-Certified____

Volleyball       X-Registered____     R-Recognized____     C-Certified____

 

RETURN FORM WITH YOUR CHECK TO:        Lyle Meador

                                                                                President DAOA

                                                                                #11 Park Ct.

                                                                                Oreana , IL  62554-9778

                                                                                217-972-2568

Press the print button to print the form. Mail the form and your fee amount to the DAOA.