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