New User Registration


	STOP - READ THIS FIRST DO NOT USE THIS FORM IF YOU ARE A CURRENT OR PAST USSF REFEREE, ASSESSOR, INSTRUCTOR, OR ASSIGNOR If you are a current or past USSF referee, assessor, instructor, or assignor, then you are already registered to access this website. Click HERE to go to the login page and follow the directions to obtain your password.

Membership to this website is "Private." If you wish to REGISTER FOR A NEW REFEREE CLINIC OR CLASS, or an assessor, instructor or assignor clinic, please complete the following to gain access to the website. Do not use this form if you are a current referee and wish to register for a Referee Recert Clinic. Instead, click HERE to go to the login page and follow the directions to obtain your password as an existing USSF referee, assessor, instructor, or assignor. Once your account information has been submitted, the Administrator will be notified and your application will be subject to a screening procedure. If your request is approved, you will receive notification of your access to the website. PLEASE NOTE: You will not be approved to access this website until you have registered as a new referee by clicking the "Submit" button below and pay the applicable USSF Registration fee through Paypal as directed.

Membership to this website is "Private." If you wish to REGISTER FOR A NEW REFEREE CLINIC OR CLASS, or an assessor, instructor or assignor clinic, please complete the following to gain access to the website. Do not use this form if you are a current referee and wish to register for a Referee Recert Clinic. Instead, click HERE to go to the login page and follow the directions to obtain your password as an existing USSF referee, assessor, instructor, or assignor.

Once your account information has been submitted, the Administrator will be notified and your application will be subject to a screening procedure. If your request is approved, you will receive notification of your access to the website.

PLEASE NOTE: You will not be approved to access this website until you have registered as a new referee by clicking the "Submit" button below and pay the applicable USSF Registration fee through Paypal as directed.

Registering as a:*

RefereeAssignor

First Name:*

Middle Name:

Last Name:*

Password:*

Confirm Password:*

Display Name:*

Email Address:*

Street:*

Apt/Suite:

City:*

Country:*

State:*

Zip Code:*

Telephone:*

Cell Phone:*

Work Phone:

Gender:*

MaleFemale

Country of birth (required by USSF):*

Country of citizenship (required by USSF):*

Birth Date (mm/dd/yyyy - required for USSF):*

Current Age:*

Have you ever been convicted of a felony, a crime of violence, any crime against an individual, or fraud?:*

NoYes

Provide biography information for your user profile:

* 255 character limit

Please provide an image for your profile: