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What's your name?
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What's your surname?
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What's your gender?
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What's your ID Number?
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What's your SAHA Membership Number?
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What's your current employment status?
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Which company do you work at?
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What is your occupation?
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What is the street address where you live?
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What suburb do you live in?
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Which city do you live in?
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What province do you live in?
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What country do you live in?
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What is the postal code of your area?
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What number can you be contacted on?
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What is your work number? (Optional)
Are you able to umpire?
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Which umpire level have you achieved?
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Have you played for another club before?
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Which club was your previous club?
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Have you received a clearance letter from your previous club?
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Please upload your clearance letter from your previous club?
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Alternatively you may email your clearance letter to admin@bellvillehockey.com, prior to the first game of the season.
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