2022 Community State Youth Championships

2022 Community State Youth Championships

Expression of Interest
Name*

First NameLast Name
Email (Parent / Guardian email for players)*
example@example.com
Phone Number (Parent / Guardian for players)*
Please enter a valid phone number.
Are you expressing interest to be a:*

PlayerCoachVolunteer / Team ManagerSports Training / First Aid
Parent / Guardian Name

First NameLast Name
Current Club*
Type "No Club" if not currently affiliated at a Northern NSW Football Club
Which zone is your club a part of?*
What age group are you registered in for season ?

Girls 12sGirls 13sGirls 14sGirls 15sGirls 16sBoys 12sBoys 13sBoys 14sBoys 15sBoys 16sOther
What age group do you currently coach?

Girls 12sGirls 13sGirls 14sGirls 15sGirls 16sBoys 12sBoys 13sBoys 14sBoys 15sBoys 16sNot currently coachingOther
What is the players Date of Birth

MonthDayYear
Date
Please outline below your experience and any relevant qualifications for the position:
Clicking submit will provide this information to your member zone. They will contact you after the closing date of 20th May to confirm fiurther details including trials and / or training.
Should be Empty: