2016
NEW SOUTH WALES COMBINED HIGH SCHOOLS SPORTS ASSOCIATION
ATHLETICS OFFICIALS NOMINATION
STATE CHAMPIONSHIPS – WEDNESDAY 7 SEPTEMBER THURSDAY 8 SEPTEMBER, FRIDAY 9 SEPTEMBER 2016
SYDNEY OLYMPIC PARK ATHLETICS CENTRE
***RETIRED TEACHERS – MUST ALSO COMPLETE SECTION 9 BELOW
1. Name: Mr/Mrs/Miss/Ms
2. School:
Address: ………………………………………………………………………………………………………………………………Post Code:
School Telephone: ……………………………………… Fax: ……………………………….. Mobile: ………………………….……………………………………….
Email Address: ………………………………………………………………………………………
3. Association (Region) School is affiliated to:
4. I wish to apply for the following positions in order of preference (select from the following table):
Track Umpire / Starter’s Marshall / Computer Recording (Meet Manager)Call Room Marshall / High Jump Official / Long Jump / Triple Jump Official
Shot Put Official / Discus Official / Javelin Official
1) 2) 3)
6. Availability of Officials (please complete by circling days you are available)
Wednesday Thursday Friday OR All Three (3) Days
*Please Note: From 2016, officials may be used for 1, 2 or all 3 days depending on requirements. Priority will be given Experienced and Qualified officials. Additionally a quota system will be utilised to included new/beginning officials.
7. Polo Shirt Size (please complete by circling correct size): Adult sizes - XS S M L XL XXL XXXL
8. Previous Experience:
Zone Level:
Region/Association Level:
State Level:
9. *** FOR RETIRED TEACHERS ONLY – IMPORTANT - must complete this section
In order to be eligible for consideration you must also provide one (or both) of the following and ATTACH copies of the document/s to this application:
ACTIVE DoE CASUAL TEACHING NUMBER: ……………………………………………………………….…………………………………
CURRENT WWC NUMBER: ………………………………………………………………………………….………………………….…….……..
Date of Birth (for verification purposes): …..…………………..…………………………………………………………………..…………
School last taught at: ………………………………………………………… Region/Association: ……………………………………...
Signed: Date:
10. Principal’s/School Education Director’s (if applicable) Recommendation:
Signed: Date:
11. Sports Coordination Officer (Region/Association) Endorsement:
Signed: Date:
Closing Date: Friday, 5 August 2016 – No nominations will be accepted after this date.