Support Personnel | Application Form 2024-25

Full Name*

First NameLast Name

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mobile Number*

E-mail*

example@example.com

What club or sporting organisation are you currently associated with?

What is your current role in your sport?

Working With Children Check (WWCC) number*

WWCC expiry date*

Date of birth*

Date

Indicate the position you are interested in*

What are you current coaching qualifications?

Current CPR (Cardiopulmonary Resuscitation)

YesNo

Current First Aid

YesNo

Coaching background and experience, incl. qualifications and dates, teaching, program development etc

NEW CLUB is committed to developing potential on and off the field. To assist you with your coaching skills and development please indicate the areas you would like support. For example, furthering your coaching accreditation*

What are your coaching aspirations?

Sporting referee

Referee Name

Street Address Line 2

TelephoneEmail

Sport Program

The NEW CLUB will consider appointing a Head Coach, Manager, Assistant Coach, Trainee Coach and Sports Trainer for each program. The Head Coach and Manager will work in conjunction with the Technical Director (TD)

Responsibilities include:

Deliver training sessions as outlined in the program schedule.
Supervise athletes in your care.
Attend NEW CLUB training sessions and events
Contribute to the planning and development of the program.
Assist in the liaison with State Sporting Organisations (SSO), regional associations and/or clubs.
Participate in professional development opportunities.
Contribute to the reporting process as required.

An appointment in a program role with NEW CLUB is on a voluntary basis. A typical employer-employee relationship does not exist between the two parties. An honorarium arrangement may be agreed to offset expenses incurred in relation to the service/s provided.

All appointments will be made for a period of one year, subject to satisfactory conduct and service. NEW CLUB reserves the right to cease the appointment arrangement at any time. Decisions can be made at the discretion of the Board.

All program personnel must adhear to the NSW Government Office of Sport Conduct and Behaviour, Play By The Rules. https://www.playbytherules.net.au/conduct-and-behaviour

Any breaches of conduct or complaints will be handled through the Compliments, Complaints and Suggestions process.

Selection:

The selection panel may consist of executives, Board Members and a representative from the respective SSO.

Successful nominees will be appointed by the NEW CLUB TD, and notified accordingly.

Please add any other comment/s to support your application

Should you be successful, please provide your current bank account details. *

Account Name

Bank

BSB Number

Account Number

I, insert your full name , nominate myself for the position/s indicated above with the NEW CLUB.

I have read the information listed above and agree to abide by these statements and policies.

Signature

Date

Please verify that you are human*

For further information please contact:

Martin Rae, Technical Director

Phone: (02) 6766 2526
Email: td@nias.org.au

Soccer Support Personnel Application Form