TO Assessment Notification

TO Assessment Notification
This form notifies Swimming Victoria of Technical Official assessments, which are done according to the Assessment Criteria.

Both the Assessor and Assessee will receive an email notification of the form submission. Please make sure the details below are correct.

JoS, IoT & Starter roles, must first pass the online modules, apply the knowledge, and gaining experience on pooldeck first, prior to their assessment.
Assessor Details
Assessor Name

First NameLast Name
Assessor Email
Assessee Details
Assessee Name

First NameLast Name
Club Name - current season member
Current Season Member
Email
Assessee email address
WWCC (Working with Children's Check) Number
WWCC expiry date
ddmmyy
Community Officiating Essential Skills Course (COES) completed
ASSESSMENT DETAILS - Position Assessed
If Starter or Referee, was this the assessee's first or second assessment?
If Starter or Referee, how many qualifying competitions have they officiated in that role BEFORE their 1st assessment. Please list the events.
Please list events and dates, or attach copy of logbook below. Competition length min 3 hours.
If Starter or Referee, how many qualifying events have they officiated in that role AFTER their 1st assessment? (for those doing their 2nd assessment). Please list the events.
Please list the events and dates, or attach copy of logbook below. Competition length min 3 hours.
Please attach a copy of the logbook

Please attach a copy of the events you have officiated at in that position
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Online course or EXAM completion date

DayMonthYear
Date DD MM YYYY
Practical assessment date

DayMonthYear
Date DD MM YYYY
Meet Name and Location - must be a minimum of 3 hours
eg 2024 Vic LC Qualifying meet MSAC
Confirm the Assessment Tool paperwork was signed by both you, as the Assessor, and the Assessee
ASSESSMENT DECISION
Assessor feedback and recommendations.
Has the Assessee been provided with a hard copy of the assessment tool form?
Please attach last page of the completed Assessment Tool form

Last page of the Assessment Tool must be attached
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Signature - By signing you confirm all the above details are correct and the candidate has been assessed according to the Assessment Criteria. Failure to provide incorrect or misleading information, will result in the assessment not being validated.
Should be Empty:

TO Assessment Notification

Assessor Details

Assessee Details