South West Swimming 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.

Swimming Carnival Nomination Form 2012

School Details:

Details of Teacher(s) in Charge: [Note: HOLA 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:

Please indicate preference of carnival:

My school is on MAZE. Please email me further instructions on how to submit my school name list:

My school is on SIS and therefore my school name list can be obtained from the DET:

Nominations Due: Friday Feb 10 2012

Nomination Fee: $300 TBC (SSWA will invoice schools)

When you submit this form it will be emailed to the

South West School Sports Coordinator

Tracy Cameron Margaret River SHS

Tracy.Cameron@education.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