::MSHSAA::Apply To Become An Official

Missouri State High School Activities Association

Apply To Become An Official

Personal Information

First Name:
Middle Name:
Last Name:
Suffix:

Contact Information

Home Address:
Daytime Phone:
( )   -
Evening Phone:
( )   -
Email Address:

Personal Identification

Social Security #: - -
Date of Birth:

Format: MM/DD/YYYY
Gender:
 
High School Attended:

Membership Type

Reciprocal memberships are available for individuals who live outside the state of Missouri and who are fully registered in Illinois, Iowa, Kansas, Oklahoma, Arkansas, or Nebraska. If you do not meet both of these requirements, you must select "Standard" for your membership type.

Membership Type:

Vocational Information

Vocation/Job:  
Current Employer:  

Other Information

Have you ever been convicted of a felony?

List all prior misdemeanor and felony convictions along with any extenuating or mitigating circumstances regarding such convictions.

Activity Selection

If the activity for which you wish to register does not appear in the list below, the registration deadline has passed for this year. Registrations for next year begin on May 1, 2010.

Registration Year: 2009
New Activities:






Complete Application

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