EmailMeForm
Busselton NAIDOC - Replacement/Additional Umpire
This is to be completed after the player & officials registration form has been received by NWA and an additional or replacement umpire is being added to a team. This form must be received by NWA by the date outlined in Appendix 1 of the Competition Manual.
Association/Club/Team/Grassroots Site Details
Team/Club Name
*
Primary Contact Details
Name
*
First
Last
Mobile
Email
Communication will be sent to this email address
New Umpire Details
Name
*
First
Last
Division Umpiring
*
Age Division Umpiring
Current Umpire to be Replaced (if applicable)
Name
First
Last
Division Umpiring
*
Age Division Umpiring
Name any other nominated umpires nominated that will have their divisions altered due to the above replacement/addition.
*
Please note, all requests must be approved by Netball WA before an umpire can be added to the team.
For any questions or support, please contact inclusiveparticipationprogram@netballwa.com.au
