New Affiliate Expression of Interest
Upon the completion of this form, a Member Services Coordinator will be in contact within 3-5 business days.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number
*
E-mail
*
example@example.com
Proposed Affiliate Name
Proposed venue for Affiliate competition
Proposed division/s intending to run?
*
Junior Male
Junior Female
Junior Mixed
Adult Male
Adult Female
Adult Mixed
Unsure
Have you been involved with touch football previously, and if so, in what capacity?
*
Submit
Should be Empty: