E.O.I. player profile form

2016 Elite Junior Camp Expression of Interest

• Name*
  First Last
• Address*
  Street Address City ZIP / Postal Code
• Date of Birth*
  DD12345678910111213141516171819202122232425262728293031

  MM123456789101112

  YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920
• How did you find out about the Elite Junior Camp ?*
  Via my ClubVia my CoachVia my LeagueVia a DFS Coach / FB Private messageVia a friendVia Facebook/Twitter/InstagramOther
• Please indicate how you found out about the Elite Junior Camp ?*
• 2016 Local Football Club*
• 2016 Age Group*
• League*
  NFLYJFLEDFLRDFLEFLWRFLFDJFLMPJFLSMJFLSEJOther
• Name of Local League you played in*
• Your email address
• Name of your Parent / Guardian ?*
  First Last
• Email Address (Parent / Guardian)*
• Mobile Number (Parent / Guardian)*
• Name of your 2016 local team Head Coach*
  First Last
• Mobile number of your local team Head Coach*
• Email Address of your local team Head Coach*
• Did you trial for your 2016 Inter-League representative team?
  Yes I trialed, but I wasn't selected in the teamYes I trialed, and I was selected in the teamNo I didn't trial this year
• List previous and current football achievements*
• Rate yourself from 1-24 on talent level within your 2016 local team (IE, if you rate yourself at 5 that means you believe there are 4 more talented footballers within your 2015 team)*