intent to compete in diii

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NATIONAL WHEELCHAIR BASKETBALL ASSOCIATION OFFICIAL INTENT TO COMPETE IN DIVISION III Team __________________________________________________________________ Address ________________________________________________________________ Street _________________________________________________________________ City State Zip/Postal Code Phone Daytime (____)__________________ Evening(___)_____________________ E-Mail Address_________________________________________________________ Team intending to compete in Division III for upcoming season: Explain in detail how your team meets the current Division III guidelines: Provide a complete team roster (include any anticipated player transfers). If approved, this will be considered your final roster for the upcoming season. Provide a list of Novice players, including Class and Age. I certify that all the information is accurate and true: Print Name ______________________________________________ Position on Team _________________________________________ Signature _______________________________________ Date ____________ Submit all completed forms and team rosters to Buddy Barnes at 2027 Park Terrace SE, Decatur, AL 35601, or e-mail at cdd3commish@gmail.com or Fax# 256-686-1022 by: August 15 th Annually

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NATIONAL WHEELCHAIR BASKETBALL ASSOCIATION

OFFICIAL INTENT TO COMPETE IN DIVISION III

Team __________________________________________________________________ Address ________________________________________________________________ Street _________________________________________________________________ City State Zip/Postal Code Phone Daytime (____)__________________ Evening(___)_____________________ E-Mail Address_________________________________________________________ Team intending to compete in Division III for upcoming season: Explain in detail how your team meets the current Division III guidelines: Provide a complete team roster (include any anticipated player transfers). If approved, this will be considered your final roster for the upcoming season. Provide a list of Novice players, including Class and Age. I certify that all the information is accurate and true: Print Name ______________________________________________ Position on Team _________________________________________ Signature _______________________________________ Date ____________

Submit all completed forms and team rosters to Buddy Barnes at 2027 Park Terrace SE, Decatur, AL 35601, or e-mail at [email protected] or Fax# 256-686-1022 by:

August 15th Annually