SCHOOL SPORT WA

PO Box 8224, Perth Business Centre, WA 6849 ABN: 25 492 318 440 school.sport@education.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.

Primary Country Tennis Champion Schools

**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.

D'Arcy Slater Country Tennis Classic Nomination Form 2012

ACADEMY PLATE (YRS 1-7) - COUNTRY EVENT

Please ensure you check all event terms and conditions prior to nominating.

School Details:

School Name:

Suburb:

School Phone:

Details of Teacher(s) in Charge: [Note: Principal and Teacher in charge of this sport both required]

School Principal
First	Surname	Email	Mobile
Teacher coordinating this sport in school
First	Surname	Email	Mobile
Contact Person at event
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: D'Arcy Slater Country Schools Tennis Classic, Academy Plate Nomination (Yrs 1-7) - Country

Country Venue: (please tick nearest venue if entering Country Event)

Geraldton	Busselton	Katanning
Mandurah	Albany	Narrogin
Narembeen	Cunderdin/Quairading

Please select the quantity of teams you wish to enter in the relevant competitions

Academy Plate MIXED

Nominations Due: 22 February 2012

Nomination Fee: $55.00 per team [Schools will be invoiced by School Sport WA]

When you submit this form it will be emailed to the Tournament Director.

Elle Mazza

Tennis West Tournament Director

Tel: 6462 8303 emazza@tennis.com.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