Illinois Track and Cross Country Officials Association
Membership Application
January 01, 2008 to December 31, 2008

Name____________________________________________________________________

Mailing Address___________________________________________________________

City______________________________________State__________Zip code__________

Home Phone_____________________Work
                                       Cell                          

E-Mail Address_______________________________________

Check One   Official________Coach________Other_____________IHSA ID Number______________

Member (Check all that apply)  IHSA_______USTAF________College Conference_______________

Official's Certification with IHSA:  Registered_______Recognized______Certified________

How many years as a coach________ official___________

Would you be willing to serve ITCCOA in some way?_________

Membership dues are $15.00.  

Make checks payable to ITCCOA.

Copy and print this page and
Send to:

Thomas Todd                                         
2327 Westminster St.           
Wheaton, IL 60189                              
tracknfieldguy@aol.com
630-871-8896

       
Membership Application
Membership Application