Level 4 Officials Upgrade/Renewal Form
Officials upgrading from Level 3 or renewing a Level 4 accreditation
Application Type
*
Upgrade
Renewal
Ridernet Licence Number
*
Ridernet Licence Expiry Date
*
-
Day
-
Month
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Day
-
Month
Year
Sex
*
Male
Female
Non-Binary
Which Official position are you seeking accreditation for?
*
Steward/Referee
Clerk of Course
Race Secretary
Technical Officer
Measurer
Starter
Judge
Timekeeper
Announcer
Observer
Trail Boss
Which discipline/s are you seeking accreditation for?
*
Enduro
Minikhana
Motocross
Road Race
Speedway
Track/Dirt Track
Trials
Please select the type of Seminar or Refresher course you attended
*
Please Select
Technical Officer
Race Secretary
Clerk of Course
Steward
Please enter the date of Seminar or Refresher Course you attended
*
-
Day
-
Month
Year
Date
Please upload your Working With Children Check
*
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Please upload your Competency Assessment
*
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Please upload your Participation Journal
*
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Clerk of Course and Steward Only - Please upload a copy of your CoC or Steward Report
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Please upload a copy of your Motorcycling Australia Level 4 Official Upgrade/Renewal Form
*
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of
DISCLAIMER: I confirm that the details contained in this application are accurate to the best of my knowledge. I have read and understood the MA Officials Accreditations, Upgrades and Renewals document, and I agree to the terms and conditions of this application. I further agree to Motorcycling NSW Limited disclosing my name and contact details for meeting purposes.
*
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