Athletics Australia Team Staff Nominations
PLEASE NOTE: If you submitted a nomination for any 2024 teams earlier in 2023, you do not need to submit this form again.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Role you wish to nominate for:
*
Team Coach
Team Manager
Performance Support
Performance Support role:
Physiologist
Sports Dietician
Physiotherapist
Soft Tissue Therapist
Support Staff (e.g. Personal Care Assistant/Support Worker/ Occupational Therapist)
Biomechanist
Doctor
Osteopath
Back
Next
Next of Kin
Name
*
First Name
Last Name
Relationship to you
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Back
Next
Passport Information
Please list all details exactly as they appear on your passport
Full Name as per Passport
*
First Name
Other Given Names
Last Name
Passport Number
*
Passport Issue Date
*
-
Day
-
Month
Year
Date
Passport Expiry Date
*
-
Day
-
Month
Year
Date
Date of Birth
*
-
Day
-
Month
Year
Date
Place of Birth
*
This is the city you were born in, not the country.
Nationality
*
Passport Country of Issue
*
Please upload a copy of the ID page of your passport.
*
Browse Files
Drag and drop files here
Choose a file
PDF preferred. Max file size 10MB
Cancel
of
Back
Next
Travel Information
Please select your closest airport
*
Sydney
Melbourne
Brisbane
Perth
Adelaide
Canberra
Hobart
Darwin
Other
Are you prepared to be fully vaccinated against COVID-19 before travelling?
*
Yes
No
Allergies
*
Dietary Requirements
*
Back
Next
Skills and Experience
Business Name (if applicable)
ABN (if applicable)
Involvement in Athletics (in 50 words or less)
*
Coaching Experience (in 50 words or less)
*
Team Management Experience (in 50 words or less)
*
Academic Qualifications (in 50 words or less)
*
Please outline (in 50 words or less) the qualities you would bring to this position and why you would like to be involved in Athletics Australia's High Performance Program
*
Back
Next
Personal Referee
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Position/Occupation
*
Back
Next
Team Nomination
*staging camp attendance will also be required prior to competition (approx. 2 weeks)
Please select the Athletics Australia teams you wish to nominate for:
*
FISU World University Cross Country Championships: 17-18 Feb 2024 (Muscat, OMA)
World Athletics Indoor Championships: 1-3 Mar 2024 (Glasgow, SCO)
World Cross Country Championships: 30 Mar 2024 (Belgrade, SRB)
World Athletics Racewalking Teams Championships: 21 Apr 2024 (Antalya, TUR)
World Athletics Relay Championships: 4-5 May 2024 (Nassau, BAH)
World Para Athletics Championships: 17-25 May 2024 (Kobe, JPN)*
Oceania Athletics Championships (Senior Team Only): TBC Jun 2024
U23 Development Tour: TBC June 2024
Olympic Games: 26 Jul-11 Aug 2024 (Paris, FRA)*
World Athletics U20 Championships: 20-25 Aug 2024 (Lima, PER)*
Paralympic Games: 28 Aug-8 Sep 2024 (Paris, FRA)*
Are you willing to provide support at domestic-based High Performance Camps and Competitions, if required?
*
Yes
No
Back
Next
Terms of Nomination
Athletics Australia Code of Conduct
I have read, and am willing to sign and comply with the Athletics Australia Code of Conduct.
*
Yes
No
I have completed, or will complete before departure on tour, Sport Integrity Australia's Anti-Doping Fundamentals course.
*
Yes
No
I have completed, or will complete before departure on tour, Sport Integrity Australia's Annual Update (formerly Level 2) course.
*
Yes
No
I have completed, or will complete before departure on tour, Sport Integrity Australia's Competition Manipulation and Sports Betting course.
*
Yes
No
I have completed, or will complete before departure on tour, Sport Integrity Australia's Coaches Course.
*
Yes
No
I have completed, or will complete before departure on tour, Sport Integrity Australia's Medical Practitioner Course.
*
Yes
No
I have completed, or will complete before departure on tour, Sport Integrity Australia's Child Safeguarding in Sport Induction Course.
*
Yes
No
I have a current Working With Children Certificate (or equivalent i.e. WWVP, Blue Card) and am willing to provide Athletics Australia with a copy for their records.
*
Yes
No
WWWC
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature
*
Submit
Should be Empty: