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u14 State Championships Team Officials Nominations

8th and 9th June

Northern Hockey Centre, 240 St Leonards Rd, St Leonards

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Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Region*

Which position do you wish to nominate for?*

1st Team Preference*

2nd Team Preference

Do you have a Working with Vulnerable People check? If yes, please provide the registration number and date of expiry. A Working with Vulnerable Children Check will be required from successful applicants*

Yes

WWVP Card No*

WWVP Expiry Date*

Do you have any Hockey Coaching Accreditation?

Teams currently or previously coached or managed (include grade and details) in the last 5 years Max. 255 characters

Detail any other experience you have that is relevant for the position you're applying for Max. 255 characters

Contact Email*

Contact Number*

I have read and understand the Social Media Policy linked on the nomination page*

Yes

I have read and understand the Code of Conduct linked on the nomination page*

Yes

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

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