Springfield Area Sports Officials Association

Application for Membership

Name: ____________________________________

Address: ___________________________________

City: ______________________________________

Zip: ________ E-Mail: _____________________

IHSA Official #: ________________     Registered, Recognized, Certified.  ( Please circle )

Home Phone: ( ) __________________________

Work Phone: ( ) __________________________

Mobile: ___________________________

Pager: ____________________________

Circle sports you officiate:   

Baseball     Basketball     Football     Softball    Volleyball                   

$ 30.00 Dues included:     YES     NO

Mail completed application with dues to:  Springfield Area Officials Association
                                                       Box 1074
                                                       Springfield, IL  62705