Join Us Head Coaches Form

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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:

RENEWAL FORM FOR HEAD HIGH SCHOOL OR COLLEGE COACHES and THEIR STAFF ONLY

All others Join here

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 below. All required fields are marked with *.

Indiana Basketball Coaches Association
Membership Application

MEMBERSHIP INFORMATION:

* School:

* Type:

* I am a:

Annual Fees:

$20.00

$15.00

Active Coaches - includes a one million dollar liability policy

Former Coaches, Officials & News Media. Does NOT include insurance.

* District:

District?
(1, 2 or 3)

* Name:

High School Name:

Address:

City:

State:

Zip:

Phone:

Fax:

* Email:

Enter the Names of ALL Coaches you are renewing for Below. $20 EACH Coach.

First Name	Last	Title	Status	Email

Please print this form and mail FORM and a CHECK 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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