SFA-T01A FORM

PERSATUAN FLOORBALL
NEGERI SELANGOR TEAM REGISTRATION FORM Ref. no:
(No. Ruj. 7052/2014) TEAM NAME: Date:
Manager
Signature:
Address: No. 24, Jalan 10/3, Taman Putra, 68000 Ampang, Selangor Darul Ehsan Contact: +6 017 237 3940 Email: selangorfloorball@yahoo.com
INSTRUCTIONS
1 All fields are complusory to be filled up in CAPITAL LETTERS, except for those under "For SFA use only".
2 Players to signed in Form SFA - T01A shall be bounded to the team named aboved and shall abide to the SFA constitution, bylaws rules and regulation.
3 Designation: M = Manager; AM = Assistant Manager; C = Coach; GK = Goalkeeper.
4 To cross out unused rows, if any.
5 Two (2) copies of SFA -T01A must be submitted. i) Hard copy (with players signature) with other forms and all payments by hand; ii) Softcopy via email.

NRIC/ Passport / Birth Players' For SFA use only

No Name (as per NRIC/ Passport) Gender Age Designation
Certificate No Signature Form New Late Remark
( F/ M ) ( M / AM / C / GK ) (ref. no). (1/2)
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