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Grassroots Referee Course Scholarship Application
Colorado Soccer welcomes all who are interested in and serious about becoming a referee. Our goal with this program is to ensure initial registration fees do not prohibit anyone from becoming a referee.
Referee Registration payment includes:
* Referee course work, instruction and administrative fees
* US Soccer Registration fee
* Administrative fees association with the online course
** This program does not include the cost of the NCSI background check, which is required for all referees age 18 and over by US Soccer. **
Application Date
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Applicant's Name
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First
MI
Last
Date of Birth
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All candidates must be past their 13th birthday in order to certify as a US Soccer Referee
Email
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Primary Contact Phone
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Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
I verify that I am at least 13 years old and will create a referee account in the US Soccer Learning Center (learning.ussoccer.com)
Yes
No
If I am age 18 or over, I understand that I must complete SafeSport training and the US Soccer-required NCSI background check in the US Soccer Learning Center.
Yes
No
If I am age 18 or over, I understand that I am responsible for all fees related to the NCSI background check in the US Soccer Learning center. I understand that all fees related to the NCSI background check will not be included in this scholarship program.
Yes
No
It is my responsibility to complete all online and in-person coursework for the grassroots referee certification. I understand that all online assignments must be completed before the in-person session.
Yes
No
Referee Course Payment / US Soccer Registration Agreement
I understand that I am completing the US Soccer Grassroots Referee Course which is a hybrid course of online learning and an in-person session so that I can become a US Soccer Grassroots Referee.
Yes
No
To reimburse Colorado Soccer/Colorado Referees for the expenses involved in my registration, I agree to meet the following requirements after being registered as a US Soccer Grassroots Referee
1) I will work a minimum of five (5) CSA Advanced League youth games (Centennial League, Colorado Champions League, Mountain Region League) within 30 days of completing my certification course work (and background check if required)
2) Out of the five (5) required CSA Advanced League youth games I work within the first 30 days of my registration, a total of $90 in referee fees will be retained by CSA/Colorado Referees to pay for my referee course.
Yes
No
Please specify the Grassroots Referee Course you wish to attend.
Each access code is unique and only works with a specific course.
Courses are set up by the date/location of the in-person session. You can choose from the list of courses at this site - https://tinyurl.com/uuf5evsj
(You may need to copy and paste this link in your browser)
Upon receipt and approval of this application, the State Director of Instruction will provide you an access code for the referee course in the US Soccer Learning Center. Following completion of the course, you will create an account in Gameofficials.net, complete all required payroll documents and be assigned to work CSA youth league games
Yes
No
Applicant Signature
Clear
If under age 18, a parent/guardian signature is required
Clear
