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Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Do you have relevant coaching accreditations?*

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Do you have a valid Working With Children Check?*

Yes

No

Do you have your own transport?*

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No

Training Schedule Availability*

Coaching Level Preference*

Premier Mens

Premier U19 Boys

Premier Womens

Premier U19 Girls

Youth U15/U17

State League Divisions Men

State League Divisions Women