WAFC AFL Girls Champion Schools

**Enter your details and press submit at the bottom of page**

Please do not print a blank form and hand write your details as your nomination will not get through to the SSWA sport coordinator.

Nomination Form 2012

School Details:

School Name:

Suburb:

School Phone:

Details of Teacher(s) in Charge: [Note: HOD/TIC Phys Ed and Teacher in charge of this sport both required]

School HOD/TIC Physical Education
First	Surname	Email	Mobile
Teacher coordinating this sport in school
First	Surname	Email	Mobile
Important: All relevant sport information and competition updates will be sent to these email addresses
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 is aware of, and endorses, this team(s) nomination. Yes (Please click) Principal's Signature:____________________________________ For School Records Only: We suggest you print this form, present to your Principal and keep for your records - you are not required to bring this to the event or submit to the SSWA office.

Competition Details:

Select which division you wish to enter (White or Moore divisions)

Please indicate team coach's shirt size [S,M,L,XL etc.]

Can your school provide their own accredited umpire for your Home and Away matches? YES NO

NOTE: All school nominated umpires will be paid for their services.

If YES please provide the name of the umpire

Nominations Due: Wednesday 29th February 2012

Nomination Fee: Nil

When you submit this form it will be emailed to the SSWA Sport Coordinator:

Geoff Hayes, Tel: 9586 7354, geoffrey.hayes@det.wa.edu.au

**For your records please print a copy of the form before submitting

For security reasons we require you to enter a code word prior to hitting the submit button.

Code Word [use lowercase]: sswa Enter code word here