LAFOA - Los Angeles

Los Angeles Unit (LAFOA)

Application Instructions

Please enter the required information on the fields below.
Specify the school nearest to your home for accurate mileage fees computations
For all phone numbers, please enter the information using this format: xxx-xxx-xxxx
Information submitted on this form will be electronically sent to the Unit Secretary: Connie Wells at conniewells.launit@yahoo.com

My Application

First Name

Middle Name

Last Name

Address

City

Select State

Zip/Postal Code

School Nearest Residence

Declare Association For Playoffs

Home

Work

Cell

Select Challenge Question

Challenge Answer

Have you ever been convicted of a felony?

If yes,please explain

If applicable, to avoid conflict of interest issues please list any High Schools that you or your family members are affiliated with:

*Experience*
Level	Experience Level	Assignor	Phone Number
College?
High School?
Youth?
Comments

*Last Unit or Organization Information*
Unit/Organization Name:
Assignors Name		Phone Number
Instructors Name		Phone Number
Reason For Leaving

By submitting this form, I attest to the facts of this document and I agree to the terms and conditions as stated:

I understand that as an Independent Contractor, I am required to comply with all State and federal laws. In addition, I understand I am required by the Los Angeles Football Officials Associaton (LAFOA) to provide proof of Liability Insurance as a condition of membership. Liability insurance is NOT included in LAFOA membership fees, but proof of liability insurance must be provided prior to reciving any LAFOA game assignments.

I understand that as an active member of the LAFOA, in good standing, that I am ONLY guaranteed instructional materials and instruction and that I am NOT guaranteed game assignments.

I understand that the LAFOA is NOT responsible for my health (before, during, or after the football season) and it is my responsibility to get a physical or medical evaluation as it relates to the level of physical activity for a high level, fast-paced basketball game.

Acknowledgment Notice for Terms and Conditions

	By checking this box, I attest to the facts of this application and and agree to the Terms and Conditions of the Los Angeles Unit set forth above.

Mail 14