I INDIANA NSA 2011 - TRAVEL PERMIT for NSA QUALIFIERS ONLY Any INDIANA NSA team that wishes to participate in NSA Tournaments outside the state of INDIANA needs to fill out this form, and submit to the STATE Office no later than 30 DAYS prior to the tournament. INDIANA NSA 2011 - TRAVEL PERMIT DATE of Request:  _______________________________________________________________ 2010 NSA Registration Number:  ____________________________________________________ My team wishes to participate in the following NSA Tournament: Tournament Name:_______________________________________________________________ TRNY Date:  ___________________________TOURNAMENT LOCATION:___________________ TRNY Director: _________________________AGE:_______________CLASS:_______________ Team Name: ___________________________________________________________________ Manager Name:  _________________________________________________________________ ADDRESS:______________________________________________________________________ CITY:__________________________________ZIP CODE:________________________________ Fax: ___________________________________EMAIL: __________________________________ Phone: (H) ______________________________Phone: (W) _______________________________ Managers Signature: ________________________________________ State OFFICE Approved Date: _______________ Approved By: _____________________________ MAIL TO: SHIRLEY MINNICK PO BOX 312 WABASH INDIANA 46992 This form will be reviewed by the State Office.   THIS FORM WILL BE RETURNED TO YOU TO TAKE TO THE TOURNAMENT DIRECTOR After the Travel Permit is received in office, it will take no less than one week to reply. After one week, please feel free to contact us via e-mail.  Thank you.