2020 Junior State Championships - UMPIRE Expression of Interest

2022 Outdoor Events - UMPIRE Expression of Interest Form
Thank you for taking the time to complete the 2022 Outdoor Events Umpire Expression of Interest Form.

Please note that this form is simply for Umpires to submit your expression of interest to umpire at the JCC, SCC and/or the JSC. Once expressions of interest close Hockey Victoria (in conjunction with HV Officiating Committee) will allocate umpires to panels for each event.

Expressions of interest for the JCC & SCC will close at 5.00pm on Friday 15th April and Hockey Victoria will endeavour to inform all successful candidates of their appointments within a fortnight.

Expressions of interest for the JSC will close at 5.00pm on Friday 29th April and Hockey Victoria will endeavour to inform all successful candidates of their appointments within a fortnight.
PLEASE READ THE INFORMATION BELOW BEFORE COMPLETING THIS FORM
This form is to express interest in being an UMPIRE at one of HV's Outdoor Events.

If you have come to the wrong form, below are the links to the other Officiating Expression of Interest forms. Please note that the links are all different, so please be careful to complete the correct form.

Tournament Director & Assistant Tournament Director - https://form.jotform.com/hockeyvictoria/2022-outdoor-events-TD-ATD

Umpire Manager, Assistant Umpire Manager or Umpire Coach - https://form.jotform.com/hockeyvictoria/2022-outdoor-events-umpire-managers

Technical Official (JSC only) - https://form.jotform.com/hockeyvictoria/2022-JSC-TO-EOI
Personal Information
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
E-mail*
Secondary Email Address
e.g. parents email address, should you wish for any communications to be sent to this email address as well
Phone Number*

Area CodePhone Number
What club or association are you from?
On Day contact number

Area CodePhone Number
Whose Number is this?
(Who would we be talking to on this number, and what is their relation to you, if its not you)
Do you have any medical conditions that we should be aware of?
Working With Children Check (WWCC)
If you are over 18 years of age, you will require a vaild WWCC or exemptions to fulfill any of these roles.

Please check you have added Hockey Victoria as an organisation you work with here: http://www.workingwithchildren.vic.gov.au/home/cardholders/update+your+details/

Hockey Victoria Inc.

Postal Address: P.O. Box 32 Parkville VIC 3052

Phone: (03) 9448 2100
WWCC Declaration*

I acknowledge I have updated my WWCC online to list Hockey Victoria as an organisation I work with or I am exempt from the WWCC
Grassports Junior Country Championships
The 2022 Grassports Junior Country Championships will run on the weekend of Saturday 14th May & Sunday 15th May. The venues will be as follows:
- Under 13 Boys & Girls - TBC
- Under 15 Boys & Girls - Greensborough Hockey Centre
- Under 18 Boys & Girls - State Hockey Centre
All Umpires officiating at the JCC will receive coaching across the course of the weekend anda payment of $15 per match they umpire (noting matches are shortened in length).
Which dates you are available for?

Saturday 14th May ONLYSunday 15th May ONLYBoth daysI am not available for the JCC
If you are available for the JCC, please indicate the times/days below

14th May - Morning14th May - Afternoon14th May - All Day15th May - Morning15th May - Afternoon15th May - All DayOther
Which venue would you like to ideally umpire at (you can select multiple options)?

TBC (U13s)Greensborough (U15s)State Hockey Centre (U18s)Any of the above
Will you be involved in the JCC in any other capacity?

PlayingCoachingTeam ManagerOther
If you are involved in the JCC in another capacity, which team and age group are you involved with?
Grassports Senior Country Championships
The 2022 Grassports Senior Country Championships will run from Saturday 11th June to Monday 13th June. The venues will be as follows:
- Open & Masters Women - Stead Park (Geelong)
- Open & Masters Men - Footscray Hockey Centre
All Umpires officiating at the SCC will receive coaching across the course of the weekend. In 2022, umpires will also be paid $20 per match.
Which dates you are available for?

Saturday 11th JuneSunday 12th JuneMonday 13th JuneAll of the aboveI am not available for the SCCOther
Which venue would you ideally like to umpire at?

Geelong (Women)Footscray (Men)Either of the above
Will you be involved in the SCC in any other capacity?

PlayingCoachingTeam ManagerOther
If you are involved in the SCC in another capacity, which team and age group are you involved with?
Grassports Junior State Championships
The 2022 Grassports Junior State Championships is scheduled to take place in the Term 2 school holidays.

The event will run for 4 days from Thursday 30th June to Sunday 3rd July. The venues that are being utilised are State Hockey Centre & Footscray Hockey Centre.

JSC Umpire Expressions of Interest must be submitted by 5.00pm Friday 29th April.

All umpires will receive coaching and mentoring for the duration of the Event, as well as payment of $15 per match.
For JSC, which dates you are available for?

Thursday 30th JuneFriday 1st JulySaturday 2nd JulySunday 3rd JulyAll of the aboveI am not available for the JSC
Which venue are you hoping to umpire at?

State Hockey CentreFootscray Hockey CentreEither venue
Which age group are you hoping to get appointed to?

Under 13sUnder 15sUnder 18sAny of the aboveOther
Will you be involved in the JSC in any other capacity?

PlayingCoachingTeam ManagerTechnical OfficialOther
If you are likely to be involved in the JSC in another capacity, which team and age group are you involved with?
If you have a family member likely to be playing in the JSC, please indicate the team and age group below
Is there any other information you wish to share with us?
Should be Empty:

2022 Outdoor Events - UMPIRE Expression of Interest Form

PLEASE READ THE INFORMATION BELOW BEFORE COMPLETING THIS FORM

Working With Children Check (WWCC)

Grassports Junior Country Championships

Grassports Senior Country Championships

Grassports Junior State Championships