Club Membership Application

General Information

A club desiring to become an affiliated member with NJ Youth Soccer will submit a membership application for review by the State Association.

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* 1. Club Name (Full Name)

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* 2. Club Name (DBA and/or Acronym)

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* 3. Club Mailing Address Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 4. Club Website/URL

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* 5. Club Hometown

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* 6. Please state why you are seeking membership with NJYS.

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* 7. Club Mission Statement

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* 8. Date of Club's Initial Formation

Date

Date