Ice Hockey Officials of Northern California
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CTHOA Registration

Who Are You?
Name:
  
FirstLast
Taxpayer ID / Social Security Number:
Birthdate:
  /     /  
MMDDYYYY
These data are needed in order to report your officiating income to the IRS.

How Can We Reach You?
What is your mailing address?


City:    State:    Zip:

What is your email address?
(more than one OK, separated by commas)

Home phone:      Pager:  
Work phone:      Fax:  
Cell phone:     

Which phone numbers should we list in the directory of officials?
Home Work Cell

Other Officiating Organizations
What other officiating organizations do you belong to? CTHOA encourages its officials to belong to other organizations. Working for multiple organizations aids the local hockey community, and allows officials to gain experience faster.

Professional Hockey (CHL, AHL, SPHL, etc.)
Junior Hockey (USHL, NAHL, WSHL, etc.)
College Hockey (NCAA, ACHA)
Scorekeeper
Member of NASO (National Association of Sports Officials)
Other:

USA Hockey Registration
What is your USA Hockey Official registration status?

Registration level?
1 2 3 4

Member Number?  

Liability Insurance
Do you have liability insurance to work games in non-USA Hockey leagues?
Yes
No

Personal Bio
Optional: Tell your fellow officials something about yourself. (The text in this box will be visible to all CTHOA officials.)