EmailMe Form - Membership Enquiry Form

Name of the person making the enquiry *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Mobile Number *

Email *

Confirm Email

(Complete this section if you are wanting to play for the club)

Please choose which section you are interested in?

Name of the Player

First Last

Date of Birth

Have you played for another club? if you have please list them if not just use N/A

Which position/s do you play?

(Complete this section if you are looking to join our coaching team or would like to help in some way)

Name of the Coach or Helper

First Last

Do you currently hold any of the following qualifications? If you dont thats not a problem just choose None.

Have you coached or helped at another club? if you have please list them if not just use N/A

England Netball Affiliation - Are you presently affiliated to England Netball? *

Yes

No

If yes what is your affiliation number.