Country Championships Player Recognition Form

Please use this form to register your playing history for 30, 40 & 50 years at the Victorian Country Championships

Select your age range*

Male

Female

Non-Binary

Differently identify

Enter your post code*

What is the name of yourself or the person you are nominating?*

Which club have you or the nominee represented for the majority of your playing time at Country Championships?*

How many years have you been playing in the Country Championships?*

Which period of recognition are you nominating for?*