Wishes to nominate for the 2017 25's & Under Australian Championships November 5th - 11th.

I understand that this is a self funded event and in order to be selected I will be participating in the DWA State 25’s & Under on the 16th-17th September .

I understand that nominations for the final state team will only be accepted using this form only and are to be submitted no later than September 10th 2017.