SCHOOL SPORT WA

PO Box 8224, Perth Business Centre, WA 6849  ABN: 25 492 318 440  school.sport@det.wa.edu.au

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Primary Basketball 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 sport coordinator.

Nomination Form 2012

School Details:

School Name:

 

 School Phone: School Fax:
Address:   Suburb: Post Code:

Details of Teacher(s) in Charge: [Note: Principal and Teacher in charge of this sport both required]

School Principal
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 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:

Uniform Colours:  
How many Boys Teams are you entering?                
How many Girls Teams are you entering?                
How many Mixed Teams are you entering?              
Please indicate your preference for venue? [You must list 2 preferences]
First Preference        
Second Preference   

 

School Coaching Clinics:

“Basketball WA will arrange Go for 2&5 coaching clinics to assist your school to prepare teams for the event. Please indicate your preference for start date and day of the week these clinics will occur.”

Training Day Preference:

Monday

Tuesday

Wednesday

Thursday

Friday

 Preferred start date:

Preferred start time:

Preferred finish time:

 

Nominations Due:    Term 1 Competitions - 2 March 2012;   Term 4 Competitions - 20th May 2012

Nomination Fee: $30.00 per team     (SSWA will invoice schools)

When you submit this form it will be emailed to Basketball WA

 

PLEASE NOTE THAT ONCE SUBMITTED YOUR NOMINATION HAS BEEN RECEIVED. HOWEVER PLEASE WAIT FOR CONFIRMATION FROM BASKETBALL WA TO CONFIRM YOUR NOMINATION.

 

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