Request for a Promotion Certificate

FORENAME

SURNAME

YEAR OF BIRTH

CLUB

EMAIL ADDRESS

ADDRESS
Students are advised to use their home address if possible.

POSTCODE

PHONE
If you are under 18 this should be a parent/guardian's phone number

PROMOTED AT
CLASS
ON (DATE)
(C2 ONLY) SECOND PADDLER FORENAME
(C2 ONLY) SECOND PADDLER SURNAME

(C2 ONLY) SECOND PADDLER YEAR OF BIRTH