NCOA Sacramento - REGISTRATION

Date

Last Name  First Name

Address 

Is this a new address from previous registration?  Yes   No

City CA   Zip  I

Last 4 Digits of Social Security Number 

Birthdate (Format 01/22/2007) 

Phone Home Phone Work

Phone Cell Email Address

Have you ever been convicted of a felony or crime for which you are required to register your address with your local law enforcement agency?  Yes  No

Please check all sports worked with NCOA Sacramento
 Baseball  Basketball   Football  Softball  Volleyball  Waterpolo   Wrestling

New Official:  Referred by

Member of other Sports Officials Organization

Dues:  Dues received on or before October 7, 2008 are $50 or $30 for a second sport. Dues received on October 7, 2008 or after are $60 or $40 for a second sport.  After submitting this registration form, you should mail your check to NCOA c/o Rick Willoughby, 174 Ginger Drive, Auburn, CA 95603.  Your check needs to be received prior to October 7, 2008, to qualify for the early discount registration. Make sure your name or the name of the official signing up is on your check. Your received check will be matched up to the Submitted registration list.

If you have already paid dues to another sport for this 2008-2009 scholastic year (football, volleyball, water polo ?), then your dues for basketball will be $30.00.

By submitting this form you acknowledge that:

You are a member of NCOA, not an employee of NCOA. As a member, you are an independent contractor per Section 3352 Subsection(u) of the labor code. As such:

• Payroll withholding such as taxes and contributions are not taken out your game fees
• The IRS has specific regulations concerning this type of income and how to report it.  Make certain that you comply with the IRS reporting requirements
• You are not eligible for worker’s compensation or other employment benefits as an independent contractor when accepting assignments from NCOA and/or it assignor.
   

  Please press only once and wait to receive a message from us.

Reminder:  After submitting your online registration form, mail your check for dues made payable to NCOA to:  Rick Willoughby, 174 Ginger Drive, Auburn, CA 95603.