Become A Referee
Fall, 2009 Basketball Officials Rules School
by Central Philadelphia PIAA Basketball Officials Chapter
Registration Application
Contact Information
Name
Cell Phone
Home Phone
Work Phone
Address, City, State Zip
Email
If you are a current college student, what school are you attending?
Officating Experience
Any prior officiating experience?
No
Yes
Registered for 10/05/2009 PIAA exam?
No
Yes
Already taken a PIAA basketball certification exam?
No
Yes
Already certified as a PIAA basketball official?
No
Yes
Briefly describe any prior officiating experience including # of years, locations and levels of play.
Interest
Why are you interested in participating in the Become A Referee Rules Clinic?
Comments
Fees & Sessions
Fee*: $100 (full time students and CPIAA members, $65)
Mondays (7-9:30pm): August 31, September 14, 21, 28
Tues. (7-9:30pm) Sept. 7, Thurs. (7-9:30pm) Sept. 3
Saturdays (7-9:30pm): Sept. 12, 19, 26 and October 3
Location: To Be Determined at a Philadelphia College
*Students are expected to attend all sessions and may be dismissed without refund after 3 absences.
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