QUEENSLAND CHRISTIAN SOCCER ASSOCIATION INC.
2014 SOUTHEAST ZONE COMMITEE
President Di Lense dijlense@optusnet.com.au 0411859858
Secretary Murray Collingwood murray@focus-computing.com.au
Jnr Registrar - (U10 to U13) – Leonie Skeet clskeet1@optusnet.com.au 0412 878 571
Snr Registrar - (U14 to SM) –Shaun Noffke noffke_j_@hotmail.com 0431 059 233
Treasurer Joanne Dovey –- joanne.dovey@optusnet.com.au 0434 143 135
2014 SOUTH EAST ZONE REPRESENTATIVE PLAYER NOMINATION FORM
To be considered for selection in the 2014 South East Zone Representative Team, players must complete this form & submit
it via email or bring it to Early registration day on October 26 th 2013 at Oates Park or Final Registration Day. Submission of
nomination doesn’t result in automatic selection in a 2014 South East Zone Representative Teams & nominating players
must attend the 2014 South East Zone Final Team Selection Day.
SOUTH EAST ZONE DETAILS – WHAT’S IT ALL ABOUT?
1.
QCSA South East Zone Representative Teams compete at the annual State Titles. The June Long Weekend – Saturday & Monday).
2.
South East Zone Teams are selected in the following age groups: U10, U11, U12, U13, U14, U16 Boys, U16 Girls, U18, SW &SM.
3.
South East Zone competes against other zones including North, West, Sunshine Coast and BFQ.
4.
Queensland Representative Teams are selected over the State Titles weekend in U14, U16 Boys, U16 Girls, U18, and Men &
Women’s to complete at the CFFA National Titles in September/October 2014.
South East Zone Teams may compete in other competitions in addition to the QCSA State Titles.
5.
NAME:
SOUTH-EAST
REGISTRAR
USE ONLY
D.O.B.:
CLUB:
PHONE:
MOBILE:
PLAYER DETAILS
AGE GROUP:
PLAYER ID:
E-MAIL:
POSTAL:
UNIFORM ORDER & PAYMENTS
PRICE
2012 REQUIREMENT
TEAM POLO
$35.00
COMPULSORY for new
players
SHORTS
$25.00
COMPULSORY for new
players
SOCKS
$10.00
COMPULSORY for new
players
HAT
$15.00
OPTIONAL
HOODIE
$39.00
OPTIONAL
UNIFORM
(per player)
REGISTRATION
TBA
QUANTITY
DATE
AMOUNT
INFORMATION
PLEASE NOTE FINAL
PAYMENT REQUIRED
BEFORE
COMPULSORY
A MINIMUM DEPOSIT OF $50.00 IS REQUIRED on 14 March
DATE
SIZE
CASH

CASH
CHEQUE

PLEASE MAKE CHEQUES PAYABLE TO
“SOUTH EAST ZONE SOCCER”
CHEQUE
TOTAL
RECEIPT NUMBER
DEPOSIT
BALANCE
REGISTRAR
SIGNATURE
PLAYER / PARENT DECLARATION: (PARENT SIGNATUREREQUIRED IF PLAYER UNDER 18 AT DATE OF SIGNING).
I recognize that the above information is correct and can be used by the South East Zone& QCSA for registration purposes. I also
acknowledge that once selected, I will be required to meet any associated costs, training programs & practice matches for all listed
competitions.
Name:
Signature:
Note: Nomination doesn’t result in automatic selection in the 2014 South East Zone representative team. Team selection by team management or South
East Zone Selectors