2025 Football Advisory Panel Nomination Form

PRIVACY STATEMENT

FV will only collect, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth). FV may use and/or disclose personal information collected from you in this form, or by virtue of checks or searches undertaken (including disclosure to FV’s officers, employees, professional advisors, and any person to whom by law FV must provide any such information), including for the purposes of the FDC Committee nomination process. Without limiting the foregoing, FV may make public the fact that you are ineligible to be nominated as an FDC member, but FV will exercise due care in relation to sensitive information. You may access and read FV’s current privacy policy here.

NOMINATION INFORMATION YOU WILL NEED

Before you get started you will need the name, position and contact details (mobile and email address) of the President or Authorised Delegate of the Voting Member Club or Director supporting your nomination so that we can make contact with them to confirm your nomination.

ATTACHMENTS REQUIRED

To complete this form you will need the following documents/attachments:

A photo of your current Working with Childrens Check Card (minimum Volunteer WWCC) to upload
A passport style photo of yourself to upload in .jpg or .png format

Candidate's Name* This field is required.Name of the authorised representative who is submitting the application on behalf of the Club.

First Name

Last Name

Candidate's Contact Numnber* This field is required.Mobile phone number preferred

Candidate's Contact Email* This field is required.

example@example.com

Candidate's Gender* This field is required.

Candidate Statement* This field is required.In 50 words or less, tell us why you should be a part of The Football Advisory Panel.

0/50

Candidate Bio* This field is required.Please provide a short bio stating your skills and experience in 250 words or less.

0/250

Football Experience* This field is required.Please select all the areas of football experience that apply to you (both current and previous)

Administrator / Committee Member

Coach

Referee

Player

Team Manager

Physio / Medical / Strength and Conditioning

Miniroos Football (up to U11s)

Junior Football (U12 - U18)

Senior Football

Men & Boys Football

Women & Girls Football

Advanced Pathway Football (e.g. NPL)

Community Football

Regional Football

Schools Football

All abilities & inclusion football

Social Football

Futsal

Beach Soccer

Member Protection / Safeguarding / Policy

Government Relations / Funding

Facilities

Grievance, Disciplinary & Tribunal (GDT)

Football Marketing / Social Media / Journalism

Football Production (Live Broadcast / Commentary)

Football Business Operator / Private Academy

Player Agent / Intermediary

State / National Team Pathways

Name of Club Supporting Your Nomination* This field is required.If an FV Director is supporting your nomination please select Football Victoria as the Club.

Contact Details of Authorised Delegate at your Nominating Club* This field is required.

Full Name of Nominator

Position of Nominator

Mobile Number of Nominator

Email Address of Nominator

Candidate Working With Children Check (WWCC)* This field is required.Please upload a PNG or JPG image of your valid and current WWCC

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Candidate Photo* This field is required.Please upload a high resolution colour PNG or JPG passport style photo of yourself. This photo will not be published publicly without your permission.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

I declare and acknowledge that the information entered throughout this application is a true and accurate at the time of lodgement.* This field is required.

Yes

Signature* This field is required.

2025 Football Advisory Panel Nomination Form