Poomsae World University Games EOI
Name
First Name
Last Name
D.O.B
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What University are you currently studying at?
EVENT AND DIVISION (Please enter the division you wish to be considered for and include any partner / team name(s) as appropriate - you may only enter a maximum of 2 divisions)
Individual
Please Select
Yes
No
Mixed Pair
Please Select
Yes
No
If you selected Mixed Pair please state the name of your partner
Teams
Please Select
Yes
No
If you selected Teams please state the names of your partners
You confirm you are an Australian Citizen and have a current Australian passport or eligible to hold a valid Australian Passport?
Please Select
Yes
No
You confirm you wish to be considered for selection for World University Games?
Please Select
Yes
No
Signature
Submit
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