Referee Registration

First Name:
Last Name:
SS#:
Address:
City:
State:
Zip:
Cell Phone:
E-mail:
First Aid Certification:
First Aid Expiration:
CPR Certification:
CPR Expiration:
Current Referee Certification:
Referee Association Name:
Commissioner Name:
Commissioner Phone:
Have you officiated adult basketball games?:
Where?:
What league, or leagues?:
How many games have you officiated?:
How did you hear about PSBL's referee opportunities?:

By selecting I agree I am confirming I have printed and read the rules and policies, and directions to the gyms.

By selecting I agree I am allowing the league send me a Referee Contract and Invoice Sheet.
 I agree