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 Tennis Interstate Trial Nomination

Bruce Cup

**Enter your details and press submit at the bottom of page**

Nomination Form 2012

School Details:

School Name:
Suburb:
School Phone:

Competitor Details:

First Name:
Surname:
Email Address:
Date of Birth:
Important: All relevant sport information and competition updates will be sent to this email address:
Contact No:
Parent / Guardian Details
First Name:
Surname:
Email Address:
Contact No:
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 nomination. Yes (Please click) Principal's Signature:____________________________________ Please print this nomination form and present to your Principal for authorisation. To participate in the trials a copy of the form, with Principal's signature, must be presented on the day of the trial.

Competition Details: BRUCE CUP

Current Tennis Club:
Current Coach:
Coach Contact Number:

I wish to be considered for selection in the SSWA Bruce Cup Cup Team and agree to abide by the decisions of the selectors.

(Please Click)

Nominations Due: 6th June 2011

Nomination Fee: $20 per person

Please bring money to trials - cheques made payable to School Sport WA

When you submit this form it will be emailed to the trials organiser:

Andrea Rundle

andrea.rundle@det.wa.edu.au

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

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