Gold Eastern Territory Qualifier App

NOTE:  This is an entry application only.   Information entered here will be submitted to the tournament director and populate the team entry spreadsheet only.

Your entry is not official until the ASA Official Tournament Entry form signed by your State/Metro Association and entry fee check (made payable to "ASA of PA" in the amount of $440) is received.  Send to:  Tina Sanders, 266 S Christian St., Cleona, PA 17042

Players will be required to sign-in and provide Photo ID's.  Coaches must provide 2012 ACE Certification and/or 2012 ASA Background Check credentials at check-in and display credentials throughout tournament.

 

*
Team Name*
ASA State/Metro Association*
Manager's Name *
First Name
Middle
Last Name
Manager's Address *
Address Line 1
Address Line 2
City
State
Postal Code
Phone*
Alt. Phone (Cell)*
Email*