MBA SUMMIT INVITAIONAL 2026 NOMINATION FORM

MBA SUMMIT INVITAIONAL NOMINATION FORM

This form is for nomination purposes only and does not guarantee selection or a place in the event
Please enter your 2025/26 MBA membership number.
Preference is given to 2025 members
Have you been an MBA member at any other time
If you dont know your number, we will email it to you
Previous MBA number pre 2025
Male or Female

MaleFemale

Name*

First NameLast Name
Where are you from ?*
Please write city and state
Mobile Phone Number - Please make accurate input*

Country CodeMobile number
Email - Please make accurate input*
example@example.com
How many fights have you had *
Wins*
Losses*
What class do you wish to nominate for *
Please note that Cadet class means 0 fights in any other combat sport
What age group are you nominating for

30-4041-5051-5556-6061-70
What age will you be on June 20 - 2026
What Weight Class are you aiming for ?*

50-57.5 - (Female Only57.5 - 65 - Lightweight65 - 72.5 Welterweight72.5 - 80 - Middleweight80 - 87.5 - Cruiserweight87.5 - 95 - Heavyweight95-102.5 - Super Heavyweight102.5 - Open Weight
What is your weight today*
Do you have a Trainer*

yesNo
Trainers Name

First NameLast Name
Trainers mobile phone number

Country codeMobile Phone Number
Email
example@example.com
Please name your gym
Titles and Fees*

Summit Combat and Cadet Tiltes - FEE $120 AUDOpen Class State Title - FEE $200 AUDOpen Class Australian Title - FEE $300 AUDOpen Class World Title - FEE $500 AUD
Important information

I understand that submitting this form does not guarantee me a place in the event.
• All nominations close on 16 February.
• I will be notified of the outcome of my nomination on or before 1 March 2026.
• Masters Boxing Australia reserves the right to refuse any nomination or proposed match-up.
• I understand all applicable fees and agree to pay these in full by 1 May if my nomination is successful.
• I acknowledge that I must be a current financial member of Masters Boxing Australia (MBA) to compete if selected.
I aknowlege the above*

yesno
Should be Empty:

MBA SUMMIT INVITAIONAL NOMINATION FORM