New Member Application

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If you are interested in joining the Rock River Officials Association, please attend a meeting and announce your intentions.  A listing of meeting dates and times can be found on the website.  A copy of the membership application can be downloaded from the file sharing page of this website.  Below is a sample of the application.  We look forward to you joining our association.

 

 

Rock River Officials Association
Registration and Dues Application Form
2007-08 Season
All my personal information, as listed on the RROA web site, is current…YES:NO:
NAME:       
ADDRESS:       
CITY:    ZIP:  
HOME PHONE:    AGE:  
OTHER PHONE:    D.O.B.  
EMAIL ADDRESS:       
* Must have email
I am currently a licensed official in the state of Illinois…YES:NO:
If YES, my I.H.S.A. identification number is... # 
If NO, I plan to get/have my license by this date…  
SPORT:LEVEL OF CERTIFICATION:Years officiated
  RegisteredRecognizedCertifiedin this sport
Baseball     
Basketball    
Football     
Soccer     
Softball     
Track/Field    
Volleyball    
Wrestling    
Membership - $35.00 (due on/before June 30th)Amount:$ 
Late Fee - $5.00 (after June 30th) Amount:$ 
Total:$ 
Make checks payable to R.R.O.A.
Please mail this completed form with payment to:
John Kereven, Treasurer
Rock River Officials Association
313 Ada Street
Rock Falls, Illinois  61071
All information listed is accurate as of this date…
Signature:    
Date: