2023-24 PSFCA Online Membership Registration

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, simply scroll to the bottom of PayPal log in screen and click on Credit / Debit Card box to complete the registration process with your chosen card and information.

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.

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 - $85.00Staff Including Clinic - $550.00

Payment Type *Credit / Debit CardCheck

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