Athletic Commission Officials Application

Officials Form

Welcome to the online payment system for the Kansas Athletic Commission. This form is for officials.

License Type

Please select which of the following licenses you are applying for.

 
 
 
Referee License

Please select which of the following licenses you are applying for.

 
 
 
Judge License

Please select which of the following licenses you are applying for.

 
 
 
Name and Address Information
Required Field
Required Field
Required Field
Required Field
Required Field
Required Field
Contact Information
Required Field example: 555-555-5555
example: 555-555-5555
Required Field
Additional Information
Required Field format: MM/DD/YYYY
Convictions

Have you ever been convicted of a crime (except minor traffic violations)? If yes, please list them in the area below.

 
 
List of Convictions
Legal Disclaimer

I hereby certify and attest that all of the information provided herein is true and accurate. I acknowledge the right of the Kansas Athletic Commission to verify this information and take appropriate legal action if such information is deemed false or misleading.

 
Payment Information
Payment Information
Required Field required