Team Vic Student Officials Application Form

Team Vic Student Officials Application Form

Student's Full Name

First NameLast Name
Email
example@example.com
Date of Birth

DayMonthYear
Date
Gender

MaleFemalePrefer not to say
Parent Guardian Full Name

First NameLast Name
Email
example@example.com
Mobile Number
Please enter a valid phone number.Format: 0000-000-000.
School Name
Year Level*
Does your child have any medical conditions?

NoYes
Does your child have any dietary requirements?

NoYes
Choose the sport
Australian Football - Official Type*

Field UmpireGoal UmpireBoundary Umpire
Which SSA Championships are you applying to attend?

12 Years & Under - 02 - 09 August, 2026 in Canberra, ACT14 Years & Under - 25 - 31 July, 2026 in Melbourne, VIC
Baseball - Official Type*

Plate UmpireBase UmpireOutfield Umpire
Which SSA Championships are you applying to attend?

18 Years & Under - 26 April - 02 May, 2026 in Adelaide, SA
Basketball - Official Type*

RefereeBench Official
Which SSA Championships are you applying to attend?

12 Years & Under - 25 - 30 October, 2026 in Newcastle, NSW16 Years & Under - 25 - 31 July, 2026 in Melbourne, VIC
Football (Soccer) - Official Type*

RefereeAssistant Referee
Which SSA Championships are you applying to attend?

12 Years & Under - 25 - 30 October, 2026 in Newcastle, NSW18 Years & Under - 25 - 31 July, 2026 in Melbourne, VIC
Hockey - Official Type*

Umpire
Which SSA Championships are you applying to attend?

12 Years & Under - 25 - 30 October, 2026 in Newcastle, NSW15 Years & Under - 25 - 31 July, 2026 Aug in Melbourne, VIC
Netball - Official Type*

UmpireBench Official
Which SSA Championships are you applying to attend?

12 Years & Under - 12 - 18 September, 2026 in Darwin, NT15 Years & Under - 25 - 31 July, 2026 in Melbourne, VIC
Rugby League - Official Type*

Referee
Which SSA Championships are you applying to attend?

11-12 Years - 09 - 14 August, 2026 in Kingscliff, NSW
Softball - Official Type*

Plate UmpireBase UmpireOutfield Umpire
Which SSA Championships are you applying to attend?

12 Years & Under - 25 - 30 October, 2026 in Newcastle, NSW15 Years & Under - 24 - 29 May, 2026 in Eastern Creek, NSW
Touch Football - Official Type*

Referee
Which SSA Championships are you applying to attend?

12 Years & Under - 25 - 30 October, 2026 in Newcastle, NSW15 Years & Under - 25 - 30 October, 2026 in Newcastle, NSW
Volleyball - Official Type*

First RefereeSecond RefereeLine Judge
Which SSA Championships are you applying to attend?

15 Years & Under - 25 - 30 July, 2026 in Melbourne, VIC
Highest level officiated at?*
Please upload umpire accreditation (required)*

Cancelof
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