Prime Minister's Athlete Scholarship - change of contact details form | Athletes

Prime Minister's Athlete Scholarship - change of contact details form

Please note: * = Required field (you must fill it in).

Personal details

Your NZAS region: *

Your first name: *

Your last name: *

Date of birth: *

Student ID: *

Sport: *

Event: *

Contact details

Home phone: *

Work phone:

Mobile phone:

Email address: *

Address

Permanent address: *

Term address:

Which address should we send your mail to?

Updated | 24 Sep 2007.

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High Performance Sport

Prime Minister's Athlete Scholarship - change of contact details form