Individual Information
First Name *
Last Name *
Address *
City *
State *
Zip *
Phone *
Email *
Password *
Should be 8 to 16 characters long and can be alphanumeric only.
Confirm Password *
Date of Birth *
Gender *
Other Information
Judges Organization Membership
Judge - Current Rating *
Meet Director Club Affiliation (if any)
Address
Category *
Certification Information
Date Completed *
Expiration Date *
Individual Membership Agreement
  • I understand and agree to abide by the NGA Rule Book. Initial:
  • I attest to the fact I am not on any banned or suspended list of any sport or organization. Initial:
    • By signing below, I have agreed to follow the requirements of a NGA membership and understand that failure to do so may result in loss of membership.
SIGNED: Date:
Payment Information $35 Application Fee

*Fees are not prorated. Fees are non-refundable and non-transferable

Billing Info
Card Holder Name *
Card Holder Billing Address *
Email Address *
City *
State *
Zip *
Phone *
Card Details
Card No *
Expiry Date *
(Format -mm/yyyy, ie: 01/2021)
CVC *
Signature *