CLUB STEWARDS (GRADES 1 & 2) REGISTRATION

Fill out the form below and click the submit button. The VKA will confirm your registration once recieved. * Denotes a required field.

Name: *
   
Address: *
   
Postcode: *
   

Phone/Mobile Number: *
   
Second Phone Number:
   
Fax Number:
   
Email Address: * (To be used for any addendums)
   
Retype Email Address: *

Current Stewards Grading: (check box) 1 2


Current Stewards Licence number: *



2010 STEWARDS SCHOOL TRAINING

Can you please complete below in regards to attendance of schools in 2010 so what we have some idea on numbers attending each school.
Registration need to be completed and into the VKA office by the 29th of January 2010.

Day: 6th February
City: Bendigo
Venue: Bendigo RSL, Havilah Road Long Gully
Time: 10.00am - 4.00pm		 YES I'm attending Bendigo

Day: 7th February
City: Melton
Venue: Taylors Lakes hotel, Keilor Road
Time: 10.00am - 4.00pm		 YES I'm attending Melton


Please bring two pass port sized photos for your licence and credentials

Current officials licence


Special dietary needs please complete for either days:

(Your form details will be checked by the VKA)









 
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Fax: (03) 5449 6442 - Email:vka@bigpond.net.au
 
 

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