OFFICAL’S DISTRICT PLAYOFF REGISTRATION FORM

BASKETBALL 2008-2009

NAME _______________________________________________

ADDRESS ____________________________________________

HOME PHONE ______________________  BUSINESS TELEPHONE #_____________________

E-MAIL ADDRESS __________________________________

GRADUATED FROM WHICH HIGH SCHOOL_______________________________

CHAPTER AFFILIATION _________________________________

YEARS AS A PIAA BASKETBALL OFFICIAL _______________

PLEASE LIST YOUR CLOSED DATES BETWEEN FEBRUARY 13, THRU FEBRUARY 28, 2009

________________________               ___________________

________________________               ___________________

________________________               ___________________

RETURN BY NOVEMBER 30,  2008 TO:

BOYS PREFERENCE                                    GIRLS PREFERENCE
TOM BRADY                                                 FRANCES PIERCE
607 BALDWIN AVENUE                              1209 LOCUST STREET 
NORRISTOWN, PA 19403                            NORRISTOWN, PA 19403

IF EMPLOYED BY A SCHOOL DISTRICT, LIST DISTRICT:
 _____________________________________________________________

To be eligible for consideration to work District and State Playoffs, you
must: Have been a REGISTERED PIAA Official for at least five(5) years
as Varsity Experience Only. In addition, you must be scheduled/work
FIVE (5) varsity games during The 2008-09 season.