West Michigan Officials Association Registration
Name *
Prefix
First *
Last *
Suffix
MHSAA# *

Check if first year member of WMOA
 First year member 
Check if information is unchanged from last year
 same contact info as last year 

Contact Information

Home Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Home Number

###		-
###		-
####
Work Number

###		-
###		-
####
Cell Number

###		-
###		-
####
Email *
enter again to confirm *


Sports Registered to Officiate with MHSAA *
 Football 
 Girls Basketball 
 Boys Basketball 

Status as assigned by MHSAA

# Varsity ratings determines status: 0-5= General, 6-15= Supplemental, 16+= Approved
Football
Status for 2011
 General 
 Supplemental 
 Approved 
Basketball
Status for 2011-12
 General 
 Supplemental 
 Approved 
Football position
 Referee 
 Umpire 
 Line Judge 
 Head Linesman 
 Back Judge 

For MHSAA reporting purposes ONLY

Your response is optional
gender (optional)
race (optional)

Registration Status *

Registration Status

ACTIVE MEMBERSHIP --
Includes: patches, directory, and banquet ticket

ASSOCIATE MEMBER ONLY --
Includes directory and banquet ticket
-- Associate membership shall be open to all past members not presently participating in high school athletics who desire mailings and end-of-year banquet ticket

You must also make your membership payment through PayPal or mailing a check.

Your registration is not complete until payment is received. You will receive a confirmation email from the WMOA.
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