Officials

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Officials

* Indicates required question

Full Name *

Your answer

Phone Number *

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Club (if applicable)

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Nominating for *

Memorial Shield

State Championships

Required

Nominating for *

Coach

Assistant Coach

Statistician

Umpire

Manager

Selector

Other:

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Please Indicate Accreditation Level *

N/A

One

Two

Three

Four

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Do you have a valid Working with Children card *

Yes

No

Please add your WWC number below

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Comments

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