Nomination Form - Winter Academy
Nomination for the RSA Winter Academy Program May - August 2026. Open to those currently in Year 10-12.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Date of Birth
*
-
Day
-
Month
Year
Date
Height
*
Weight
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School and/or club 2025-2026 Season
*
Main crew and coach for 2025-2026 season
*
Notable water results in 2025-2026 season
*
What is your 2000m erg PB? mm:ss.00
*
Date of your 2000m erg PB
*
-
Day
-
Month
Year
Date
What is your preference?
*
Sculling
Sweeping
No preference
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Emergency Contact Name
*
First Name
Last Name
Emergency Contact Relation
*
Emergency Contact Email
*
example@example.com
Emergency Contact Phone
*
Please enter a valid phone number.
Format: 0000 000 000.
Do you have any relevant medical conditions we should be aware of?
*
I acknowledge that there is a $250 fee for participation in the RSA Winter Academy.
Yes
Submit
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