2018 AFL Coaches Association Next Coach Registration
Please complete the following
PERSONAL DETAILS
First Name: *
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Surname *
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Email: *
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Phone Number: *
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Club currently Coaching / Playing at: *
Your answer
PAYMENT - CREDIT CARD DETAILS
Card Number
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Expiry Date:
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C.C.V.
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NOTE
* Payment will only be processed once you have been accepted and confirmed into the Program. An Invoice/Receipt will also be sent to you.
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