2008 - 2009 Membership Application

Complete this form and submit it or print and mail to Joe Erwin at the address at the bottom of the page.

Name

Address

City       State     Zip code   

Cell phone:   Work Phone    Home Phone 

eMail   

Basketball Camps Attended 2007-2008

Basketball Officiating Experience:

By submitting my name I hereby attest that the above information is accurate to the best of my knowledge.

I also agree to abide by the bylaws of the ECBOA and the Florida High School Athletic Assn.

Choose Dues Amount  $90 Dues and Camp   $45 Dues Only   $55 Dues after October 10th

Required iSignature  and date   

When you click submit you will receive a dated confirmation page. Save or print it for your records and for proof of registration. If you do not receive a confirmation page you may print this form and mail it to Joe Eirwin.