IKF Event Official Registration

IKF
Event Official
Registration Form
To Register Print out This form & MAIL to the IKF
With Your 2" x 2" Headshot Photo of yourself and your
Fee of $40.00 for ONE Certification & $10 For Each Additional
Add $5.00 to total If Paying by Visa/MC.
Your Fee includes Your IKF Officials Shirt, Certificate & ID Card
CREDIT CARDS Will Be Charged Thru Our
IKF/ISCF Graphics Department and Say
FOSTER GRAPHICS on your statement.
FAX: (916) 663-4510

IKF STAFF USE ONLY

SENT: ___/___/___ - REC: ___/___/___ - AMOUNT PAYING: $______
- - - - - - "PLEASE PRINT NEATLY" - - - - - -
If we cannot read your printing, YOUR REGISTRATION WILL NOT BE ACCEPTED
Registration Forms WITHOUT FEES will be Disposed of.

First & Last Name _______________________________________________________
P.O. Box Or Physical Street Number:_________________________________________
City: _______________________State: ______ Zip: ________________
Contact Number For Officials Page: (______) _______________________
E-Mail For Officials Page (PRINT CLEARLY!): ______________________________
You have been APPROVED and or CERTIFIED by the IKF to be an Official IKF:
- _____ JUDGE ONLY: $40
- _____ REFEREE ONLY: $40
- _____ TIMEKEEPER ONLY: $40
- _____ REPRESENTATIVE ONLY: $40
- _____Combination Certification. $40 for first Certification + $10 for each ADDITIONAL Certrification.
Please Confirm Certification Below:
- _____ I took an IKF Certification Course.
  - WHEN: ___________________________________________
  - WHERE: __________________________________________
  - IKF INSTRUCTOR:________________________________
- _____ Due to My Experience I Was Approved without an IKF Certification Course.
  - Who was the IKF Official that Approved You: _______________________________________
  - WHEN: _______________________________
If you wish to have an e-mail address included in your listing please e-mail it to us along with your headshot photo in a jpg format to HERE.
I certify the above Is true and I confirm so by my signature here:________________________
Date: ___/___/___

Please send all required information and fees to: IKF/ISCF Attn: EVENT OFFICIALS DEPARTMENT
P.O. Box 1205, 9385 Old State Hwy, Newcastle, CA, 95658, USA - FAX: (916) 663-4510