Supporteroos v Nepal Sign-up Form

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Please provide some information about yourself to register for a Supporteroos match v Nepal in Canberra at 4pm on October 10 at AIS.

Email *

First name *

Last name *

Mobile phone number *

Preferred position *

Goalkeeper

Defender

Central midfielder

Winger

Forward

Coach

Supporter

Please describe your soccer skill level/experience *

Your level of commitment for this match *

100% commitment

Would like to play but not ready yet to commit 100%

I can't play this match but would like to be informed about future Supporteroos opportunities

Who will you play for? *

Aussie Supporteroos

Nepal Supporters United

Spectator

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