State League Licence Expression of Interest

State League Licence Expression of Interest

Use this form to express your club's interest in a Volleyball WA State League Licence. This is an EOI, not a full licence approval. Please provide your current details, indicative or in-progress evidence, and a clear plan to demonstrate how your club will meet or exceed the minimum 120-point threshold.
Club Details & Contacts
Club Name
Club ABN (if applicable)
Club Legal Entity Type
Club Postal Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Primary Club Contact - Full Name

First NameMiddle NameLast Name
Primary Club Contact - Email
example@example.com
Primary Club Contact - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Licensing/Competition Contact - Full Name

First NameMiddle NameLast Name
Licensing/Competition Contact - Email
example@example.com
Licensing/Competition Contact - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Club President - Full Name

First NameMiddle NameLast Name
Club President - Email
example@example.com
M01 Education Programs
M01 - Education Programs
M02 - Pathways & Programs
M03 - Declarations
M04 - Education Programs
M05 - Child Protection and Welfare
M06 - Athelete Contract Template
M07 & M08 Venues & Facilities
Training Venue Name(s)
Training Venue Address(es)
Training Venue Access Type

Other
Upload Evidence of Training Venue Access

Cancelof
Competition Venue Name(s) (If Hosting Home Rounds)
Competition Venue Address(es)
Competition Venue Access Type

Other
Upload Evidence of Competition Venue Access

Cancelof
Confirmation that Competition Venue Meets VWA Facility Guidelines and FIVB Rules
M09 Club Treasurer / Finance Officer Club Contact (Not Licence Applicant / President)

First NameLast Name
M10 & M11 - Head Coaching and Assistant Coaching
M12 - Awards Night Support
M13 Participation Support – Programs Currently Delivered or Will be Delivered
Participation Support – Program Details
State League Points Criteria (Competition & Development, Participation)
Clubs must select the criteria through which they intend to achieve the required 120 points for accreditation. Financial penalties may apply if a nominated criterion is not achieved.Clubs may nominate criteria totalling more than 120 points without penalty. If a nominated criterion is not met, the club may be permitted to complete an alternative criterion within the same cycle year to maintain eligibility.
CD01 Youth League Teams - Points Claimed
Youth League Teams (CD01) – Predicted Number of Teams by Age Group
CD02 Coach/Referee Development - Points Claimed
Coach / Referee Development Activities (CD02)
CD03 Coach/Referee Accrediations - Points Claimed
Coach / Referee Accreditations (CD03)
CD04 Sanctioned Club Competitions - Points Claimed
Sanctioned Youth Development Competitions (CD04)
CD05 State League Teams - Points Claimed
State League Divisions - Men (Predicted Amount)
State League Divisions - Women (Predicted Amount)
P01 Kids & Junior Volley Programs
P01 When do you plan on running these programs?
P02 Play Volley Programs
P02 When do you plan on running these programs?
P03 Inclusion Volley Programs
P03 When do you plan on running these programs?
P04 Social Volley Programs
P04 When do you plan on running these programs?
Open Division Teams (P05) - How many teams do you forsee entering into this level of competition.
Points Calculation & Narrative
Estimated Total State League Licence Points
Declaration & Sign-Off
Authorised Signatory Full Name

First NameLast Name
Position / Role of Authorised Signatory
Date of Declaration

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Declaration Acknowledgement
Signature of Authorised Signatory
Should be Empty:

State League Licence Expression of Interest

Club Details & Contacts

M01 Education Programs

M07 & M08 Venues & Facilities

State League Points Criteria (Competition & Development, Participation)

Points Calculation & Narrative

Declaration & Sign-Off