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2017 Newcastle Junior Boys Representative Nomination
By completing and submitting this nomination form you are confirming your availability for all carnivals for your relevant age group.

U18 Boys - HNSW Indoor State Titles @ Goulburn - 24-26 November 2017

U15 Boys - HNSW Indoor State Titles @ Central Coast 13-16 October 2017

U13 Boys - HNSW Indoor State Titles @ Orange - 3-6 November 2017

If Newcastle is not your primary association you will need to obtain a clearance from your primary association prior to being considered for selection.

Nominations for all age groups are open. Trials are to be held as follows:-

U18 Boys - TBA

U15 Boys - TBA

U13 Boys - TBA

We will contact you at the nominated email address to advise these details. If you are not available to attend the trial you must contact Kay Johnston prior to the trial dates.

Note: If you are nominating for more than one age group you will need to lodge a separate form for each age group.

Contact Kay Johnston (Selection Convenor) on 0417 676 265 if you require further information.

Nominated Team *
Surname *
Your answer
First Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Contact Phone 1 *
Primary contact phone number (Mobile preferred)
Your answer
Contact Email 1 *
Primary contact email
Your answer
Contact Phone 2
Secondary contact phone number (Mobile preferred)
Your answer
Contact Email 2
Secondary contact email
Your answer
Club Registered *
Nominated Postion 1 *
Nominate your preferred position
Nominated Postion 2 *
Nominate your second choice of position
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