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Become A Referee Spring, 2010 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?

Officiating Experience

Any prior officiating experience? No Yes     Registered for 06/07/2010 PIAA exam? 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 (students and cpiaa members, $75)

Sessions (7-9:30pm) on Wednesdays: April 7, 14, 21, 28, May 5, 12, 19 ,26, June 2; and Saturday June 5 Location: To Be Determined at a Philadelphia College

*Students are expected to attend all sessions and may be dismissed without refund after 3 absences.