Diving Secondary Champion Schools Individual Nomination – SSWA

Diving Secondary Champion Schools Individual Nomination Form

School Details
Full School Name*
Suburb*
Parent/Guardian Information
Name*
First Last
Address*
Street Address City ZIP / Postal Code
Email*
Enter Email Confirm Email
Mobile Number*
School Notification*
- I understand it is a parent/student responsibility to notify the school of this nomination.
Individual Competitor Entry
Student Name*
First Last
Date of Birth*

Day
Month
Year
Gender*
- Male
- Female
Select Diving Division*
Comments
This field is for validation purposes and should be left unchanged.