I want to join SSOA

Name:

Address:

City:

State: Zip:

Phone:

Cell Phone:

Email Address:

Sports I Officiate:
IHSA Rating:

IHSA Official Number:

Years Officiating:

Year Member of SSOA:

Mentoring Program:

I want to be mentored (Optional)

SSOA Dues ($40 before July 31st, $50.00 after July 31st)
Send check payable to "SSOA" to:
Marilyn Dykstra
322 Brighton Ln
Crete, IL 60417