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Official NTISO MEMBERSHIP Application form
Applicants  MUST meet the basic A-C requirements

I have read "Membership Requirements"

*Returning NTISO Officials ONLY: Your Prior Number

Please complete this application by entering the information in the spaces provided. 

Last Name   First Name   Initial 

Address    Apt No  City 

State       Zip Code   Home Telephone 

Employer      Work Telephone 

Cellular Telephone      eMail 

Are you a High School Student  Yes     Grade

Social Security Number   Date of Birth 

I am applying to officiate in the following sports:    


I have officiated a partial season or more in the following sports:    

SCOREKEEPERS ONLY! Apply here for the following sports    


Drivers License Number:     Expires on: 
 Your drivers license was issued from the State of:  

In addition to the NTISO, I will be accepting game assignments from:


Sponsored for Membership in the NTISO by: 

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You may want to select the secured server option if it will function on your web browser.

Copyright 2012 ~ Modification Date: 2/9/2012
This document is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, and contain information intended for the specified individual(s) only.  This information is confidential. If you are not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, copying, or the taking of any action based on the contents of this information is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message.  Thank you.