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Contact Form
Please complete the contact form to express your interest for the County Rep Role
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Mobile Number
*
Your answer
What is your racket sport experience? (Tick all that apply)
*
Tennis
Badminton
Squash
Table Tennis (Ping Pong)
Racquetball
Padel
Pickleball
Other:
Required
How long have you been playing Pickleball?
*
Weeks
3 Months
6 Months
12 Months
18 Months
18+ Months
Other:
What is the name of your Pickleball Club / Group?
*
Your answer
Why would you like to be County Rep?
*
Your answer
Which County are you interested in applying for?
*
Derbyshire
Herefordshire
Shropshire
West Midlands
Warwickshire
Option 5
Required
Further Comments/Questions (please provided as much detail as possible)
Your answer
A copy of your responses will be emailed to the address you provided.
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