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A D D I T I O N A L S P O N S O R S

The IBCA would like to thank the following sponsors:

Membership Application

A head coach is responsible for enrolling ALL coaches in a school system.

A head coach is responsible for enrolling ALL coaches in a school system. This includes Elementary, Jr. High and High School staff. Each coach must be entered separately. All required fields are marked with *.

MEMBERSHIP INFORMATION:

* School:

* Type:

* I am a:

Annual Fees:

$20.00	Active Coaches - includes a one million dollar liability policy
$15.00	Former Coaches, College Coaches, Officials & News Media - insurance not included

* District:

District?
(1, 2 or 3)

* Name:

Address:

City:

State:

Zip:

Phone:

Fax:

* Email:

If paying by check please print this form and mail to: Marty Johnson, Whiteland High School 300 Main Street, Whiteland IN 46184. Please do NOT use the SUBMIT button for now.

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