AUSSIEBOX LISTING REGISTRATION


YOUR NAME

NICKNAME/RING ALIAS  
WEIGHT DIVISION/s
1
 
2
MANAGER  
HOME STATE  
 
Record Wins Losses Draws Total
 
Amateur Record Wins Losses Draws Total

Titles Held
Age DOB
Height Weight in kg
Stance Reach
PLEASE CONFIRM BY TYPING "YES" IN THE BOX THAT YOU ARE LEGALLY REGISTERED AS A CONTESTANT ACCORDING TO/IN COMPLIANCE WITH THE BOXING/MARTIAL ARTS
REGULATIONS IN YOUR STATE

(Listings cannot be accepted without this confirmation)
Contact Details
Phone (Inc area code)
Fax (Inc area code)
Mobile
Email
Address
Comments
(200 word maximum)

Or mail your form to:


 Aussiebox Registration
431-437 City Road
South Melbourne 3205
VICTORIA
email: stuart@solve.com.au
Fax: +617 9690 2434

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