Hockey Boys Champion Schools Nomination

**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.

Champion Schools 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. 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:

Division:

Ross Meadows one day (7-9)

David Bell Open One Day

David Bell Open After School

Nominations Due:

Ross Meadows Shield (Yrs 7-9) - Friday 8 June 2012 - $120 per team

David Bell Cup - Friday 6 April 2012 (Home & Away) Friday 29 June 2012 (1 Day)

$175 per team for One Day Round Robin or

$75 per team for Home & Away Round Robin (SSWA will invoice schools)

When you submit this form it will be emailed to the Sport Coordinator. Where a signature is required, please forward to:

Andrew Mellor, Como Secondary College

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