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.

Golf Interstate

**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.

Team Nomination Form 2012

School Details:

School Name:
Suburb:
School Phone:

Details of Teacher in Charge:

First Name:
Surname:
Email Address:
Important: All relevant sport information and competition updates will be sent to this email address:
Mobile No:
Principal Authority: A condition of participation is schools compliance with Department of Education Policies and Guidelines. My school Principal is aware of, and endorses, this nomination. Yes (Please click) For School Records Only

Competitor Details:

First Name
Surname
Email Address
Street
Suburb
Postcode
Home Phone
Mobile
Date of Birth [dd/mm/yy]
Name of Golf Club
Name of Golf Coach (if appropriate)
Current Handicap

State Team Selection

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

Nominations Due: TBA

Nomination Fee: Nil

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

SSWA Office

school.sport@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