Bay Metro Officials Association

Registration Form

Please PRINT and fill out this form completely

If the information has changed for any of these lines, please check the appropriate box.

Name ________________________________________

Address ________________________________________

City, St. Zip ________________________________________

MHSAA ID # ________________________________________

Home Phone ________________________________________

Work Phone ________________________________________

Cell Phone ________________________________________

Pager ________________________________________

E-Mail address ________________________________________

Please mark all the sports you are going to officiate this next school year.

Be sure to extend all columns you have marked.

Activity	Fee	Due Date	Amount
Football Dues	$15.00	July 1^st
Girls' Basketball Dues	$15.00	July 1^st
Volleyball Dues	$15.00	July 1^st
Boys' Basketball Dues	$15.00	July 1^st
Late Fee	$20.00	If postmarked after July 1^st
Baseball Dues	$15.00	February 1^st
Softball Dues	$15.00	February 1^st
Late Fee	$20.00	If postmarked after July 1^st
Bay Metro Officials Assoc. Dues	$15.00	Due with payment $15.00
		Total Enclosed

Return this form with your check made out to: Bay Metro Officials Association or

BMOA. Send the form and your check to:

Mark Gentle

100 Marshall Street

Essexville, Michigan 48732