Membership Application

Thank you for your interest in PVOA. Complete the following and once submitted, we will review your application and follow-up in a timely manner. Depending on when you join and for what sport, we will communicate any training sessions or meetings you need to attend and to qualify to officiate the upcoming season.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Cell/Mobile Phone *

Email *

Membership Applying For: *

Regular Membership ($40/year)
Student Membership ($15/year)

Please select one. (To be eligible for student membership, you must be currently enrolled in middle or high school.)

Sports *

Basketball
Softball
Both: Basketball & Softball

Select one to indicate which sport you are applying for – basketball, softball, or both.

Highest Level Experience *

Please indicate the highest level officiated (please provide any explanations or descriptions in the comment section to accurately convey your experience level in either or both sports).

Years of Experience *

Please indicate the total number of years officiated (please provide any information in the comment section to accurately describe your experience in either or both sports.)

Birthdate

Additional Information/Comments

Prove you're human 🙂 *

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