Interstate Officials Application Name* First Last Are you a Registered Teacher OR Currently Employed in a School?* Yes No This includes all who are employed in a school.Current School Name*If you are a retired teacher or currently not employed in a school put retired or your current place of employment.Current School Address* Street Address City ZIP / Postal Code School PhoneSelect the Sport you are applying for*Select SportAFLAquathlonBaseballBasketballCricketCross CountryDivingFootball (Soccer)GolfHockeyLawn BowlsNetballSwimmingTennisTouch FootballTriathlonVolleyballAFL – Positions*First Preference12 Boys Coach12 Girls Coach12 Boys Assistant Coach12 Girls Assistant Coach12 Boys Manager12 Girls Manager14 Girls Coach14 Girls Assistant Coach14 Girls Manager14 Boys Coach14 Boys Assistant Coach14 Boys ManagerDo you want to list any other AFL positions? Yes No AFL – Positions*Second PreferenceNot Applicable12 Boys Coach12 Girls Coach12 Boys Assistant Coach12 Girls Assistant Coach12 Boys Manager12 Girls Manager14 Girls Coach14 Girls Assistant Coach14 Girls Manager14 Boys Coach14 Boys Assistant Coach14 Boys ManagerAFL – Positions*Third PreferenceNot Applicable12 Boys Coach12 Girls Coach12 Boys Assistant Coach12 Girls Assistant Coach12 Boys Manager12 Girls Manager14 Girls Coach14 Girls Assistant Coach14 Girls Manager14 Boys Coach14 Boys Assistant Coach14 Boys ManagerAquathlon – Position*Coach/ManagerBaseball – Positions*First PreferenceCoachAssistant CoachManagerDo you want to list any other Baseball positions?* Yes No Baseball – Positions*Second PreferenceCoachAssistant CoachManagerBaseball – Positions*Third PreferenceNot ApplicableTour LeaderCoachAssitant CoachManagerBasketball – Positions*First Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager16 Girls Coach16 Girls Manager16 Boys Coach16 Boys ManagerDo you want to list any other Basketball positions?* Yes No Basketball – Positions*Second Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager16s Tour Leader16 Girls Manager16 Boys Coach16 Boys ManagerBasketball – Positions*Third PreferenceNot Applicable12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager16s Girls Coach16 Girls Manager16 Boys Coach16 Boys ManagerCricket – Positions*First Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerDo you want to list any other Cricket positions?* Yes No Cricket – Positions*Second Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerCricket – Positions*Third PreferenceNot Applicable12s Tour Leader12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15s Tour Leader15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerCross Country – Positions*First PreferenceCoach/ManagerDo you want to list any other Cross Country positions?* Yes No Cross Country – Positions*Second PreferenceCoach/ManagerDiving – Positions*First PreferenceCoachManagerDo you want to list any other Diving positions?* Yes No Diving – Positions*Second PreferenceCoachManagerFootball – Positions*First Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager16 Boys Coach16 Boys Manager18 Girls Coach18 Girls ManagerDo you want to list any other Football positions?* Yes No Football – Positions*Second Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager16 Boys Coach16 Boys Manager18 Girls Coach18 Girls ManagerFootball – Positions*Third PreferenceNot Applicable12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager16 Boys Coach16 Boys Manager18 Girls Coach18 Girls ManagerGolf – Positions*First Preference18s Boys Manager18s Girls Manager12s Girls Manager12s Boys ManagerDo you want to list any other Golf positions?* Yes No Golf – Positions*Second Preference12s Boys Manager12s Girls Manager18s Boys Manager18s Girls ManagerGolf – Positions*Third Preference12s Boys Manager12s Girls Manager18s Boys Manager18s Girls ManagerHockey – Positions*First Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerDo you want to list any other Hockey positions?* Yes No Hockey – Positions*Second Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerHockey – Positions*Third PreferenceNot Applicable12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerLawn Bowl – Positions*First PreferenceCoach/ManagerDo you want to list any other Lawn Bowls positions?* Yes No Lawn Bowl – Positions*Second PreferenceCoach/ManagerNetball – Positions*First Preference12s Girls Coach12s Girls Assistant Coach12s Boys Coach12s Boys Assistant Coach15s Girls Coach15s Girls Assistant Coach15s Boys Coach15s Boys Assistant CoachDo you want to list any other Netball positions?* Yes No Netball – Positions*Second Preference12s Girls Coach12s Girls Assistant Coach12s Boys Coach12s Boys Assistant Coach15s Girls Coach15s Girls Assistant Coach15s Boys Coach15s Boys Assistant CoachNetball – Positions*Third PreferenceNot Applicable12s Girls Coach12s Girls Assistant Coach12s Boys Coach12s Boys Assistant Coach15s Girls Coach15s Girls Assistant Coach15s Boys Coach15s Boys Assistant CoachSoftball – Positions*First PreferenceDo you want to list any other Softball positions?* Yes No Softball – Positions*Second PreferenceSoftball – Positions*Third PreferenceSwimming – Positions*First Preference10-12s Coach/Manager13-19s Coach/ManagerDo you want to list any other Swimming positions?* Yes No Swimming – Positions*Second Preference10-12s Tour Leader10-12s Coach/Manager13-19s Tour Leader13-19s Coach/ManagerTennis – Positions*First Preference12 Boys Coach/Manager12 Girls Coach/Manager18 Boys Coach/Manager18 Girls Coach/ManagerDo you want to list any other Tennis positions?* Yes No Tennis – Positions*Second Preference12 Boys Coach/Manager12 Girls Coach/Manager18 Boys Coach/Manager18 Girls Coach/ManagerTennis – Positions*Third PreferenceNot Applicable12 Boys Coach/Manager12 Girls Coach/Manager18 Boys Coach/Manager18 Girls Coach/ManagerTouch Football- Positions*First Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerDo you want to list any other Touch Football positions?* Yes No Touch Football- Positions*Second Preference12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerTouch Football- Positions*Third PreferenceNot Applicable12 Boys Coach12 Boys Manager12 Girls Coach12 Girls Manager15 Boys Coach15 Boys Manager15 Girls Coach15 Girls ManagerTriathlon – Positions*First PreferenceBoys CoachGirls CoachBoys ManagerGirls ManagerDo you want to list any other Triathlon positions?* Yes No Triathlon – Positions*Second PreferenceBoys CoachGirls CoachBoys ManagerGirls ManagerTriathlon – Positions*Third PreferenceBoys CoachGirls CoachBoys ManagerGirls ManagerVolleyball – Positions*First PreferenceBoys CoachBoys ManagerGirls CoachGirls ManagerDo you want to list any other Volleyball positions?* Yes No Volleyball – Positions*Second PreferenceBoys CoachBoys ManagerGirls CoachGirls ManagerVolleyball – Positions*Third PreferenceNot ApplicableBoys CoachBoys ManagerGirls CoachGirls ManagerHistory – Please complete information for the past 5 years*SchoolRoleYears at this school Current Employer*Do you have a Working With Children Check?* Yes No Working With Children Check Expiry Date*Home Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanÃ…land IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Work Email* Personal Email Mobile Phone*Do you have coaching qualifications relevant to the position? Yes No Coaching Qualification*Outline your experience, skills and attributes relevant to the position*List any previous SSWA experience &/or knowledge of SSWA programs*Supply any additional information to support your applicationReferee 1*NamePositionPhoneEmailReferee 2*NamePositionPhoneEmailSchool Principal Permission* I understand it is my responsibility to gain approval from my school principal to participate in the SSWA program as an Interstate Official Upload Relevant Coaching Qualifications (if applicable)Accepted file types: jpeg, jpg, pdf, doc, docx, Max. file size: 10 MB. How did you hear about this position?*Previous ApplicantSearch EngineSocial MediaWord of MouthEvent or ConferencePrinted AdvertisementOther (please specify)Other (please specify)*
