2020 QLD State Cup Referee Registration

Referee Information

Welcome to the 2020 QLD State Cup Referee Team!

Please complete the information below to confirm your attendance at the event.

Note: There will be some changes to the running of the 2020 QLD State Cup due to COVID restrictions, we will keep you up to date with these and any changes as they are made available.

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* 1. Contact Details

Name (First and Last Name)

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

2020 QLD State Cup Referee Registration

Referee Information

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* 1. Contact Details

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* 2. What is your Region?

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* 3. What is the name of your Affiliate?

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* 4. What team within your affiliate are you associated with?

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* 5. Please indicate your Referee Level

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* 6. Are you seeking an upgrade at QLD State Cup?

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* 7. Are you seeking endorsement to attend the 2021 NTL?

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* 8. Are you seeking an upgrade (Level 5 and Level 6) endorsement for the 2021 NTL?