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Representative Nomination Form
Please take your time and fill out this form accurately
Most of our communication will be via email. Please enter the email address that will be checked by your family most often.
Eligibility
School Year
-- Please Select --
Year 10
Year 11
Year 12
Year 13
Year 9
Date of Birth
--Day--
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
--Month--
January
February
March
April
May
June
July
August
September
October
November
December
--Year--
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Player's Contact Details
Player First Name
Player Last Name
Player Address
Home Phone
Cell Phone
Email
Club/School Team
Highest Rep team played for last season
Player Type
Batsman Type
-- Please Select --
RH Top Order
LH Top Order
RH Middle Order
LH Middle Order
RH Lower Order
LH Lower Order
Bowling Type
-- Please Select --
Right arm Pace
Right arm Medium
Right arm Leg Spin
Right arm Off Spin
Left arm Pace
Left arm Medium
Left arm Leg Spin
Left arm Off Spin
Doesn't wish to be trialled as a bowler
Keeper?
Yes
No