Details

2025 Masters Indoor Invitational Challenge - EOI Umpires & Technical Officials

Mon 20 Jan 2025 07:00 — Wed 22 Jan 2025 23:00

Canberra National Hockey Centre, 196 Mouat Street, Lyneham, ACT

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Are you attending this event?

Yes No

Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Applicant's details

First Name*

Last Name*

Address* Max. 255 characters

Phone Number*

Email Address*

Please indicate below which position/s you wish to apply for:*

Tournament Director

Assistant Tournament Director

Umpire Manager

Umpire

Technical Official

Accreditations

Do you have a relevant and CURRENT Hockey Ed Accreditation*

Yes

If Yes - What type and level of Hockey Ed Accreditation do you have and expiry date Max. 255 characters

I have an expired Hockey Ed Accreditation. Please list type and Level of Hockey Ed Accreditation and expiry date Max. 255 characters

Do you have any other expired relevant accreditations, State "A", Level 2, Level 3, FIH or other International Accreditation*

Yes

If Yes - What type and level of other Accreditation do you have and what was the expiry date Max. 255 characters

Recent Experience

I have recently umpired or officiated at (please outline recent indoor umpiring experience)* Max. 255 characters

If other, please list Max. 255 characters

Hockey Umpire and Officiating References

Referee 1 Name:*

Please detail Referee 1s role in hockey. Note they can't be HAMC Committee or Pillar Members* Max. 255 characters

Phone:*

Referee 2 Name:*

Please detail Referee 2s role in hockey. Note they can't be HAMC Committee or Pillar Members* Max. 255 characters

Referee 2 Phone:*

I have asked BOTH my referees for permission to be contacted by HAMC*

Yes

Supporting Documentation

Please upload any supporting documentation you feel may assist HA / HAMC in assessing your EOI - eg copies of accreditations, etc Combine all files into one document and upload in .pdf format

Choose file...

Max 5MB

Terms Of Registration

I confirm that I am currently registered with Hockey Australia either directly or via a Member Association.

I agree that if my application is successful, I will abide by World Masters Hockey and Hockey Australia Codes of Conduct as they apply to me before, during and after the event.

I confirm that I have read the above Terms Of Registration in its entirety.*

I agree to the Terms Of Registration.*

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

Already a member?