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- What is your Date of Birth?*
- What is your gender?*
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- What is your preferred coaching role? (Please select all that apply, and indicate primary preference)*
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- Coaching experience(last 5-10 years with most recent first)*
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- Football Coaching Qualifications/Licenses (e.g., C-Licence, B-Licence, Game Training Certificate):*
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- Are you available for pre-season training, typically commencing in November/December 2025?*
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- Are you available for Saturday match days throughout the 2026 season?*
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- Do you have any pre-existing medical conditions, allergies, or injuries that the club should be aware of?*
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- In the event of a medical emergency, do you consent to Barossa United FC staff seeking appropriate medical attention on your behalf?*
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- Should be Empty: