of01_registration.pdf (223 KB) - Florida High School Athletic ...

Instructions:
Florida High School Athletic Association
Application for Registration as a Contest Official
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For FHSAA Use Only
OF1
Revised 06/12
1.
2.
Type the form and complete EVERY item.
Return application and fee to: Officials Registrar, FHSAA, 1801 NW 80th Blvd, Gainesville, FL 32606-9176.
Date Received:
3. To avoid a $10 late fee, applications for fall sports must be received in the FHSAA Office by Aug. 5,
winter sports by Sept. 30, spring sports by Jan. 3.
Amount Paid: $
4. You must be at least 18 years old to register (a student official must be at least 16).
• Applications without a date of birth will not be processed.
• Applications without a daytime phone number and e-mail address will not be processed.
• Applications without a sport name, exam site and local association FOR EACH SPORT will not be processed.
5. One (1) FHSAA State Series Pass is made available to each registered official for purchase. This pass costs $50 and will admit the bearer only, with proper ID,
admittance to all District, Regional and FHSAA Finals state championship contests in all sports.
This application is for (check one): First-Time Registration Renewal of Existing Registration Student
Name: _________________________________________________________________________________________________________________________________
E-mail Address (required): _________________________________________________________________________________________________________________
Date of Birth: __________ / __________ / ____________________ Five-Digit ID #: _______________
Month Day Year
Mailing Address (street, route or PO Box): ___________________________________________________________________________________________________
City: _______________________________________________________ State: ______ Zip Code: __________
Daytime Phone Number (required): ( _______ ) _______ – ____________ Ext.: _________ Check if football clock operator ONLY
Sport Exam Site* Name of Local Association (do not abbreviate) Fee
1. ____________________________________________ ____ ____ _______________________________________________________ @ $41.00
Line 1 MUST be used first, regardless of any previously submitted applications
2. ____________________________________________ ____ ____ _______________________________________________________ @ $27.00
3. ____________________________________________ ____ ____ _______________________________________________________ @ $27.00
4. ____________________________________________ ____ ____ _______________________________________________________ @ $27.00
* - Dates, sites and site codes accompany this form. List two-digit codes only. State Series Pass: Yes (payment enclosed) @ $50.00
Have YOU ever been arrested for a felony? You MUST check one: Yes No
If YES, check ONE of the following: I am enclosing copies of all documentation regarding my arrest(s).
I already have provided copies of all documentation regarding my arrest(s).
For FHSAA Use Only
Processing fee .............................................................. $20.00
Late fee $10.00 (if applicable) ......................... $ _______ .00
TOTAL (fees are non-refundable) ................ $ _______ .00
If arrested for, or convicted of, a felony, you must submit a police/court report verifying reason, date of arrest/conviction, and conclusion of the incident followed by
a letter of reference from either a person in the judicial system or local officials association officer.
By my signature I acknowledge and agree that approval of my application WILL NOT constitute an employment agreement between myself and the Florida High School
Athletic Association or its member schools. Rather, I will act as, and be considered to be, an independent contractor while serving as an FHSAA registered official. I also
agree to be bound and abide by all of the FHSAA’s rules and regulations governing the conduct of contest officials at FHSAA sanctioned events.
By signing this document you will be obligated to view one FHSAA online rules video presentation and take the FHSAA rules examination for each sport for
which you register as a contest official. Pursuant to the Jessica Lunsford Act, it also will be necessary for each school or school district to check your name against
the state and national listings of sexual offenders and sexual predators.
Applicant’s Signature: _____________________________________________________________________________________ Date: _________________________
--- Applications without a signature and date will not be processed ---

Florida High School Athletic Association
Application for Registration as a Contest Official
Sport
Football
Swimming
Volleyball
Basketball
Soccer
Wrestling
Baseball
Flag Football
Lacrosse
Softball
Track
Water Polo
Dates of 2012-13 FHSAA Rules Exams
Exam
75 minutes
50 questions
8/8-8/17
8/13-8/22
10/15-10/24
10/17-10/26
1/21-1/30
1/23-2/1
1/29-2/7
2/5-2/14
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Makeup Exam
75 minutes
50 questions
9/4-9/10
9/6-9/12
11/8-11/14
11/13-11/19
2/13-2/19
2/15-2/21
2/20-2/26
2/27-3/5
Exam Sites and Site Codes for Online Testing
For the online testing, the test will be available beginning at 12:01 a.m. on day one and will end at 11:59 p.m. on the last day.
All times are Eastern Standard Time.
01 **ONLINE EXAM CODE
02 **ONLINE MAKE-UP EXAM CODE
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Revised 06/12