Application for Name Change

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Application for Name Change

This form must be completed and submitted with all required documentation to the FYSA State Office at least 30 days prior to the next scheduled BOD meeting.

Name of Organization *

Contact Person (Agent of Record) *

Email Address *

Mailing Address *

City *

State *

Zip Code *

Phone *

Fax *

Items below must accompany application:

Letter signed by current Board of Directors of the affiliate.id registration.
Proof that the DBA, legal name change, and/or registration of a fictitious name has been filed with the State of Florida.

Please upload the necessary documents via the boxes listed below. (The only acceptable file formats to upload are Word/PDF.)

File Upload

We agree by application to follow all of Bylaws, Rules and Regulations of Florida Youth Soccer Association, US Youth Soccer, and the United States Soccer Federation now in effect, as well as all of those that may be enacted in the future.

Name *

Date *

Upload Signature Here (JPEG or PNG Files)

Once this Application has been approved by FYSA’s BOD, the name will be changed on the FYSA website and on the FYSA approved registration system.