EXPRESSION OF INTEREST FORM FOR FOOTBALL CANTERBURY INC. FIXTURES COMMITTEE
Prescribed Form 23
Name of Nominee
*
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominating Member Club/Organisation Name
*
Authorised Member Club/Organisation Representative Name
Authorised Member Club/Organisation Representative Position
President
Secretary
Member on CDSFA Register (aka Delegate)
Treasurer
Vice President
Notes:
Form to be submitted no later than COB Wednesday 14 January 2026.
SUBMISSION
Digital Signature
*
I certify that the information entered above is true and correct and was entered by myself.
Submission Date
*
-
Day
-
Month
Year
Date
Submit
Clear Form
Print Form
Should be Empty: