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PCSRA

Register

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If you are not already involved with PCSRAPCSRA and would like to be, please complete the following form and click the "Register" action. Be sure to enter your birthdate, (mm/dd/yyyy), USSF Grade (9, 8 or 7) and year (2021 or 2022), and RMA clearance number (if known) and RMA expiration date.

Register for participation with PCSRA
First Name Last Name
Address
City State, Zip,
PrimaryPhone PrimaryEmail
Home Email1
Work Email2
Cellular Gender
Birthdate mm/dd/yyyy Tax Info...
USSFGrade: Year:
Notes
Action

Please enter in the Notes field a brief description of your background, which Licensing clinic you attended (for new Referees), etc. and any other information that will help us establish you as a Participant within PCSRAPCSRA.