2020 Club Contact Information

Please complete and submit as soon as your AGM has been held, or no later than 31 January 2020.

Club
Postal Address
PRESIDENT
Name Name First Last
Phone
Email
VICE PRESIDENT
Name Name First Last
Phone
Email
SECRETARY
Name Name First Last
Phone
Email
TREASURER
Name Name First Last
Phone
Email
REGISTRAR
Name Name First Last
Phone
Email
FOOTBALL MANAGER
Name Name First Last
Phone
Email
OTHER CONTACT

Is there anyone else you'd like added to our contact list?
Name Name First Last
Phone
Email
MEDIA CONTACT

This person will not be receive all correspondence but will be a point of contact at the club for news articles regarding coach appointments, social events, player milestones, etc.
Name Name First Last
Phone
Email
PREFERENCES

Please answer the following questions:
Please answer the following questions:	President	Vice President	Secretary	Treasurer	Registrar	Football Manager	Other (name below)
Contact on Perth FL website (select up to 2)	Contact on Perth FL website (select up to 2)President	Contact on Perth FL website (select up to 2)Vice President	Contact on Perth FL website (select up to 2)Secretary	Contact on Perth FL website (select up to 2)Treasurer	Contact on Perth FL website (select up to 2)Registrar	Contact on Perth FL website (select up to 2)Football Manager	Contact on Perth FL website (select up to 2)Other (name below)
Contact who will receive Perth FL invoices/statements (select up to 2)	Contact who will receive Perth FL invoices/statements (select up to 2)President	Contact who will receive Perth FL invoices/statements (select up to 2)Vice President	Contact who will receive Perth FL invoices/statements (select up to 2)Secretary	Contact who will receive Perth FL invoices/statements (select up to 2)Treasurer	Contact who will receive Perth FL invoices/statements (select up to 2)Registrar	Contact who will receive Perth FL invoices/statements (select up to 2)Football Manager	Contact who will receive Perth FL invoices/statements (select up to 2)Other (name below)
AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)President	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)Vice President	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)Secretary	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)Treasurer	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)Registrar	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)Football Manager	AGM/SGM Delegate (select 1 only. This person is the only person permitted to speak/vote at a SGM or AGM)Other (name below)
Contact authorised to place orders with Blackchrome (select up to 2)	Contact authorised to place orders with Blackchrome (select up to 2)President	Contact authorised to place orders with Blackchrome (select up to 2)Vice President	Contact authorised to place orders with Blackchrome (select up to 2)Secretary	Contact authorised to place orders with Blackchrome (select up to 2)Treasurer	Contact authorised to place orders with Blackchrome (select up to 2)Registrar	Contact authorised to place orders with Blackchrome (select up to 2)Football Manager	Contact authorised to place orders with Blackchrome (select up to 2)Other (name below)

Other Contact:
BANKING DETAILS
Bank & Branch
BSB/Account Number
Note:
Is there anything else you would like us to know?
FORM COMPLETED BY
Name Name First Last
Email

2020 Club Contact Information

2020 Club Contact Information

PRESIDENT

VICE PRESIDENT

SECRETARY

TREASURER

REGISTRAR

FOOTBALL MANAGER

OTHER CONTACT

MEDIA CONTACT

PREFERENCES

BANKING DETAILS

FORM COMPLETED BY