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17th Asia Pacific Water Polo Tournament
Hong Kong
th
14 – 16th August 2015
PRELIMINARY FORM
Federation:
Contact Person:
Address:
Telephone:
/
Country Code
Fax:
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City Code
/
Country Code
Telephone Number
/
City Code
Telephone Number
E-mail address:
We intend to take part in the 17th Asia Pacific Water Polo Tournament 2015:
YES
NO
Expected number of Players (Men’s Team):
Expected number of Players (Women’s Team):
Expected number of Officials / Coaches:
Date
Signature of President / Hon. Secretary
with Official Chop
Please return this form to HKASA office on or before 15th May 2015 (Friday)
Fax: (852) 2591 0792
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E-mail: [email protected]