AFL Girls Interstate Nomination Form

Interstate Nomination Form 2012School Details

School Name:

School Contact Person:

Email:

Address: Suburb: 

Post Code:    Phone:   Fax:

Player Nominating:

Surname:   First:   DOB [dd/mm/yy]:

Address:   Suburb:  

Post Code:   Player Email Address:

Home Phone:   Player Mobile No:

Parent Email Address:

Parent Mobile Number:

Name of current Football Club:

Current Coach: Coach Contact Number:

 Preferred playing positions: (Abbreviate - e.g. CHF, Rov, HBF etc.)

1.  2.  3.

My height in cms: My weight in kg:

Principal Authority:

A condition of participation is schools compliance with Department of Education and Training Policies and Guidelines as they relate to excursions.  My school Principal has sighted the State Trials Principal and Parent Information and  endorses this nomination.  Yes (Please click)

Parent Authority:

My parents are aware of, and endorse, my nomination:  Yes (Please click) 

Nomination Date: 23/03/12

Trial Fee: Nil

I wish to be considered for selection in the State School Football Team and agree to abide by the decisions of the selectors.  (Please Click)

When you submit this form it will automatically be emailed to:

Geoff Hayes
Mandurah Senior College

Geoffrey.Hayes@det.wa.edu.au
Contact Phone:   9583 7373

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