Mid
New Jersey Youth Soccer Association
This form must be submitted to the MNJYSA Corresponding
Secretary and faxed to the MNJYSA First Vice President no later that June 1 for
admission to the Fall season and December 1 for the Spring Season.
Name of person submitting
application: _______________________________
Phone Number
_________________________
I. Club Information
1. Name of Applying
Club: _____________________________________________
2. Number
of travel teams to be entered: _________________________________
3. Number of recreation
teams that are or will be affiliated with the N.J.
State
Association: _____________
4. Are you a team that is splitting off from a
travel club that is currently
playing
in MNJYSA? ___ Yes ___ No
If yes, please
explain why. __________________________________________
_________________________________________________________________
_________________________________________________________________
5. Are you coming from
another league? ___ Yes ___ No
If
yes, please explain why. __________________________________________
_________________________________________________________________
_________________________________________________________________
6. President: ________________________ 7. League Contact
________________
Address _________________________ Address:
______________________
________________________________
______________________________
8. Treasurer:
________________________ 9. Web manager __________________
Address _________________________ Email address
__________________
10.
Name of Bank:
________________
Club
Account # ________________
Mid New Jersey Youth Soccer
Association
Membership Application Form
II. Referee Information:
10. Submit the names
and addresses of at least 1 referee for every four teams entered.
Address
_________________________
Address _________________________
_________________________________ _________________________________
Referee
3: ________________________ Referee
4: ________________________
Address _________________________ Address__________________________
_________________________________
_________________________________
III. Field Information:
11. Number of fields to be used: __________
12. Field names and/or locations:
_______________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
13. Availability of fields: (make
special note of fields that will be shared with
in-house programs or other leagues.) __________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Attach copies of field permission slips if any fields belong
to the town.
IV. Please give other comments to support your application.