Teacher Details
Teacher Name
*
First Name
Last Name
Teacher Email
*
example@example.com
Teacher Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
School Details
School Name
*
School Address
*
Street Address
Street Address Line 2
City
State
Postcode
Rugby at School
Does your school have a rugby union program or team?
*
Yes - Program
Yes - In Curriculum
Yes - Team
No
Has RugbyWA visited your school for a Junior Force, Get Into Rugby or Tri Tag session in the past 12 months?
*
Yes
No
When would you want to take part in a clinic at your school?
*
Term 1 - 2026
Term 2 - 2026
Term 3 - 2026
Term 4 - 2026
Do you want to automatically be signed up for a free, one-day, Junior Force clinic?
Yes
No
Consent
Communications
I agree to receive communications from RugbyWA regarding the School Ambassador Program.
Please verify that you are human
*
Submit
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