The status a referee has attained and the certifying body will determine the level of football matches they are entitled to referee. Please complete the following Referee Status form.
My Name _______________________________
Address ________________________________
City ______________ State _________________
Zip Code __________Email _________________
Name of Country Federation _________________
Name of League __________________________
Name of Club ____________________________
Licenses Held ____________, _______________
| Class Number | United States Soccer Federation (USSF) License Designation | Your Country's Federation License Designation | Date Received |
| Class 12 | USSF Assistant Referee | ||
| Class 11 | USSF Associate Referee | ||
| Class 10 | USSF Linesman | ||
| Class 9 | USSF Recreational Referee |