REFEREE TRANSFER OR

REINSTATEMENT REQUEST FORM

☐ TRANSFER☐ REINSTATEMENT

General Information

Name / Date of Birth
Address
Postal Code / Email
Home Phone / Cell Phone
Previous Registration Number
Referee Classification Requested

Referee History

Year You Began Officiating / Class Obtained
Last Year You Officiated
Location (Prov/State/District & Country

From the list below, please select all that apply:

☐ / Youth Recreational / ☐ / High School
☐ / Youth Competitive / ☐ / College & University
☐ / Senior Recreational / ☐ / Tournament
☐ / Senior Competitive / ☐ / National

If you are transferring to Ontario, you must attached a photocopy of your previous referee documents in English, French or provide a certified translation from any other language (at your expense) to English.

If you are requesting a reinstatement, please explain (use additional sheet if required):

ONTARIO MATCH OFFICIAL CLASSIFICATIONS

District Match Official / May officiate soccer in the youth recreational divisions and in amateur soccer at the Youth or Senior Levels.
Regional Match Official / May officiate soccer in any category of amateur soccer and as an assistant referee in non-amateur soccer.
Provincial Match Official / May officiate soccer in any category of amateur soccer, or if recommended, act as a match official or assistant referee in non-amateur soccer and inter-provincial games

CANADA SOCCER

Nominated National Match Official / A Provincial Match Official who is selected by the province to be considered for National status by Canada Soccer.
National Match Official / May officiate soccer at any level of game nationally, including non-amateur and inter-provincial games.

Match Official & Personal Identification Documents

Submit photocopies of all available documents with this form and forward by mail to the address listed above. Applicable documentation includes:

  • Referee Identification Card of Book
  • Referee Assessments
  • Fitness Test Results
  • Reference Letter from Recognized Soccer Association
  • Passport or Birth Certificate
  • Driver’s License (with Photo)

I request permission to register as a Match Official in Ontario. I certify the information I have provided to be true to the best of my knowledge. I understand that the information I provide will be verifies with the relevant soccer authorities.

Signature / Date

Authorization

The above mentioned Match Official has been approved to officiate in Ontario as a Choose an item. Match Official, subject to the completion of such tests and evaluation as may be necessary.

Signature / Date

Nicky Pearson

Manager of Match Officials Development