SCHOOL SPORT WA

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

Reproduction of the SSWA website in whole or part for educational purposes, within an educational institution and on condition that they are not offered for sale, is permitted.

Football (Soccer) 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:

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 Policies and Guidelines as they relate to excursions. 1. My school Principal is aware of, and endorses, this team(s) nomination. 2. The school agrees to abide by all rules and guidelines and in particular those that govern age eligibility. It is the schools responsibility to quantify student ages within correct age groups. 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: [Click submit button below when all teams entered]

Nomination Fee: $60 per team (SSWA will invoice schools. Schools are reminded that the fee is payable on invoice and is not refundable due to withdrawal or forfeit).

Nominations must be returned by Friday 9 March 2012

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

Paddy Rooney - Clarkson Community High School

paddyrooney1968@yahoo.com

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