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Florida Half Century Amateur Softball Association
Replacement / Updated Card
08/19/2019
Replacement / Updated Card


Full Legal Name
Permanent Home Address
City County State Zip
Telephone Number Date of Birth
Part Time Florida Residents complete this section
Months residing in Florida: From to
Street Address in FL
City County Zip
Telephone number, if different from above
Current FHC number If not known, approximate year you got your card
Reason for needing a new Card:
Lost original, same address above
Moved to a new Area - new address is above
  old address
Requesting to be Grandfathered to old area. Explanation for why you want to be grandfathered:
  I have not been on roster for any teams in new area
  I would like to be grandfathered in so I can continue to play with my current team:
   
Grandfathering Requests must go through the Chairman, Mike Knowles. Call 941 725-0790 to explain your situation. If approved, he will write the date here ______________________________
Mail:
1. Completed form
2. $15 replacement fee - Personal or Business Check / Money Order / Cashier's Check
     Payable to Florida Half Century ASA, Inc.
3. Copy of current Driver's License or proof of current residence.

Date   Signature of Applicant
Type or Print Legibly, mail this application, proof of address and fee to:
Mike Knowles
3806 30th Lane E.
Bradenton, Fl 34208
Call 941 725-0790, if questions

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Type or Print Legibly, mail this application, proof of address and fee to:
 
Mike Knowles
3806 30th Lane E.
Bradenton, Fl 34208

Call 941 725-0790, if questions

Copyright © 2019 Florida Half Century Amateur Softball Association - All Rights Reserved.

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