| CROQUET NSW INCORPORATED. |
| Nomination Form 20___ |
| I, _____________________________ accept nomination for the |
| position of ___________________________________________ |
| Nominee ____________________________________________ |
| (Signature) |
| Nominated by ___________________________________ Club |
| Club Secretary _______________________________________ |
| (Signature) |
| Date ______________ |
| Return to Croquet NSW Headquarters by July 31 |