Brisbane Men’s & Boys’ Hockey

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Umpire Registration form

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Brisbane Hockey Association Inc
PO Box 503
MORNINGSIDE Q 4170
Australia
Tel: +61 7 3899 4399
Fax: +61 7 3399 9825

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Brisbane Hockey Umpires Association APPLICATION FOR MEMBERSHIP

Please complete this form for membership of the Brisbane Hockey Umpires Association (BHUA) for the current season.

IF YOU CHANGE YOUR ADDRESS, PHONE NUMBERS, PLAYING OR COACHING COMMITMENTS DURING THE SEASON, PLEASE ADVISE THE SECRETARY IMMEDIATELY SO WE WILL KNOW HOW TO CONTACT YOU

Contact Details

First Name:

Surname:

Email:

Postal Address:

Postal Suburb:

Postcode:

Home Phone:

MobilePh:

Date Of Birth:

Blue Card Number:

Your Umpire Registration # (if known):

If you are playing this season:

Current Season Club:

Playing Details:

Playing Division:

Umpiring Details:

Umpire Qualifications:

Your Umpiring Experience:

Umpiring Preferences:

Umpire Payment Details:

Payment Type:

Account Name:

Bank BSB:

Account Number:

Other Comments

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By clicking on Submit button I agree to be bound by the Constitution and Rules of the Brisbane Hockey Umpires Association (here) .

Whilst we try to appoint members in accordance with their preferences, this Association reserves the right to appoint its members wherever and whenever required to fulfill it’s obligations to the Brisbane Hockey Association Inc

Brisbane Men’s & Boys’ Hockey

Umpire Registration form

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Brisbane Hockey Umpires Association APPLICATION FOR MEMBERSHIP