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23-24 Florida Region Affiliate Application

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2023/2024 Affiliate Application Fee - $50.00

Please use this form to affiliate with the Florida Region of USA Volleyball. It's important to renew your personal USAV Membership starting August 2nd as your organization will not be considered active until all leaders for the 2023-2024 season have a current USAV Membership, Background Screen and are SafeSport Certified.

Affiliate Director Information

First name:

Last name:

Email:

Phone Number:

Assistant Director Name (If applicable):

Affiliation Type (Check all that apply):

Indoor Event Host

Outdoor Event Host

Gender (Check all that apply):

Junior Boys

Junior Girls

Adult Men

Adult Women

Adult Coed

Organization Name:

Organization Mailing Address (Required)

Address:

Address2:

City:

Province / State:

Postal / Zip Code:

Legal Corporate Name (Enter the legal business name registered with the state):

Business Type:

If you are registering as a NON-PROFIT-Upload your IRS Determination Letter- # 5436 This is the letter that determines your Non-Profit Status. If you do not have this document from the IRS then you are not considered a Non-Profit with the government and you are not eligible to be registered as a Non-Profit with the State of Florida.:

State Where Company Registered:

Federal ID # (Enter your EIN # issued by the IRS):

Upload Current D&O Insurance Policy (If applicable):

Income Tax Filing: Do you certify that you have filed your previous year organization tax return with the Internal Revenue Service? (Note: New affiliates with less than one year of existence can select NO as this question does not apply.):

YES

NO

General Agreement: By clicking "YES - I AGREE" I am agreeing that I have read, understand, and agree to abide by the Florida Region policies and procedures. I also agree that I am legally authorized to sign up the above listed organization and that our organization, its members, and its leadership will also abide by the rules of the organization. I realize that our organizaiton's "good standing" status may be suspended for a violation, per the Florida Region Bylaws & Incident Review Policy.:

YES - I AGREE

Comments:

Method of Payment:

Person Submitting Form:

Fill out the information below and click 'Save.' When a ticket in which you are interested becomes available, we will will notify you via email.

First name:

Last name:

Email:

We added you to the wait list. You'll receive an email when spots are available.

OK