2022-23 PSFCA Online Membership Registration

Fill out the form below to register your team for the PSFCA for the 2022-23 season. New for the 2022-23 season, you can now pay online in addition to paying by check. If you still wish to pay by check, please select “Check” in the “Payment Type” drop down box. Once you fill out the form you will receive a confirmation email with a link to download and print the check payment form to send in the mail.

If you choose “Credit / Debit Card” in the “Payment Type” drop down box you will be redirected to PayPal to complete the registration process with your chosen card and information. You will ONLY receive a confirmation email when you finish paying via PayPal. You DO NOT need to have a PayPal account to complete the membership registration / purchase.

Head Coach First Name *

Head Coach Last Name *

Head Coach Phone *

Head Coach Personal Email *

Head Coach School / Work Email *

High School *

Please do not include "high school" in the school name.

Address *

City *

State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code *

High School Phone *

High School Fax

PIAA District (numbers, not roman numerals) *

Membership Level *Single No Clinic - $75.00Single Including Clinic - $125.00Staff No Clinic - $150.00Staff Including Clinic - $500.00Staff Including PSFCA Clinic & Coaches Academy Clinic - $500

Payment Type *Credit / Debit CardCheckVoucher CodeThe Funding Zone

Voucher Code

How Many Total Coaches Do You Want To Register? *01020304050607080910111213141516

2nd Coach Name

First

Last

2nd Coach Email

3rd Coach Name

First

Last

3rd Coach Email

4th Coach Name

First

Last

4th Coach Email

5th Coach Name

First

Last

5th Coach Email

6th Coach Name

First

Last

6th Coach Email

7th Coach Name

First

Last

7th Coach Email

8th Coach Name

First

Last

8th Coach Email

9th Coach Name

First

Last

9th Coach Email

10th Coach Name

First

Last

10th Coach Email

11th Coach Name

First

Last

11th Coach Email

12th Coach Name

First

Last

12th Coach Email

13th Coach Name

First

Last

13th Coach Email

14th Coach Name

First

Last

14th Coach Email

15th Coach Name

First

Last

15th Coach Email

16th Coach Name

First

Last

16th Coach Email

Check #

Submit