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
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
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