Expression of Interest

Player Surname

Player First Name

Initial

Date of Birth

Gender

Street Address

City or Suburb

Home Phone

Mobile Phone

Email Address

What age group did you play in 2011?

What age group are you applying for in 2012?

What is your preferred position?

Are you able to attend a minimum of 2 x Training sessions per week? Yes No

Do you attend any Football Academies or Programs? Yes No

Your Football Achievements

Why do you wish to join Perth Soccer Club?

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