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.

Tennis Interstate Trial 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.

Pizzey Cup Trial Nomination Form 2009

School Details:

School Name:
Suburb:
School Phone:

Competitor Details:

First Name:
Surname:
Email Address:
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 and Training 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: PIZZEY CUP

Current Tennis Club:
Current Coach:
Coach Contact Number:

I wish to be considered for selection in the State School Pizzey Cup Team and agree to abide by the decisions of the selectors.

(Please Click)

Nominations Due: Monday 2 February 2009

Nomination Fee: $22 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 Sport Coordinator.

Lee Jarvinen

Applecross SHS Tel: 9314 9337

lee.jarvinen@det.wa.edu.au

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