Entry Form
Australian Powerlifting Union LTD Version 2011.20

Form Created By: Sectio (Tyo Muir)
Email address *
Details of Competition
Event Name: Panthers State Qualifier

Event Date: 09 January 2021

Venue: PANTHERS POWERLIFTING
14A Milsom St, Coorparoo QLD 4151

Meet Director: COLIN WEBB (Email: pantherspowerlifting@gmail.com)

Closing Date for Entries: 17 December 2020

Planned Lifting Start: 09:00 AM
Details of Participant
Name *
Gender *
Date of Birth *
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DD
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APU Membership Number *
Address *
Postal Address *
Telephone *
Email *
Weight Class *
Age Group *
Club *
Name of Coaches and APU No. *
Qualifying Total (Kg) -Not Required-
Competition where qualifying total was achieved -Not Required-
Sport Integrity Australia Level 1 Anti-Doping Course https://elearning.sportintegrity.gov.au/   *
The event to be entered (Note: Fee includes APU Anti-doping levy of $15) *
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