Submit Enrollment Form - Open Soccer Alliance USA, LLC (DE) (OSA)

"*" indicates required fields

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Prospective OSA Clubs are asked to complete this application form as completely and legibly as possible. All information provided below will remain confidential by OSA and only reviewed by pertinent staff members for approval purposes:

CLUB INFORMATION:

Club Name

Club Legal Name*

Club City:*

Year Established*

Club Website

Former League*

Club Primary Owner*

Email Address*

Mobile*

% of Ownership

Please enter a number greater than or equal to 0.

Club League Contact:*

Title*

Mobile*

Email Address:*

Legal Address / PO Box

Street Address*

CIty*

State / Province / Region*

ZIP / Postal Code*

Does your club have an affiliation of partnership with a youth club:*

Yes

Name of Youth Club

Youth Club Contact

Email:

Mobile

PAYMENT PLANS	Option 1	Option 2	Option 3
PAYMENT PLANS	10% Discount. No Admin Fee	5% Discount, 50% AdminFee	No Discount, Full AdminFee
Sign Up	Payment 1 - $2,500	Payment 1 - $2,500	Payment 1 - $2,500
February	Payment 2 - $5,000
March	Payment 3 - $3,300	Payment 2 - $1,000	Payment 2 - $2,000
Paid Pre-Season	$10,800	$3,500	$4,500

March		Payment 3 - $3,000	Payment 3 - $1,000
April		Payment 4 - $3,000	Payment 4 - $1,000
May		Payment 5 - $2,150	Payment 5 - $1,000
June			Payment 6 - $1,000
July			Payment 7 - $1,000
August			Payment 8 - $1,000
Sept			Payment 9 - $1,000
Oct			Payment 10 - $1,000
Nov		5% Late Fee Month, No Pay No Play	10% Late Fee Month, No Pay No Play

Total Pay	$10,800	$11,650	$12,500

CLUB INFORMATION:

CLUB INFORMATION & HISTORY QUESTIONNAIRE:

Choose an Payment Option

Payment

1. Make a payment

Scan a QR code or

2. Submit THE ENROLLMENT FORM