BMX Staff Expression of Interest

:: 2019/2020 ACADEMY SPORTING SCHOLARSHIP PROGRAMS
EXPRESSION OF INTEREST:
Details About You:: First Name:

Last Name:
Address:: Line 1:

Line 2:

City:

Country:

State:

Postal Code:
Mobile Phone:
Email:
Confirm Email:
BMX Club/Association:
:: MANAGEMENT / COACHING EXPERIENCE / QUALIFICATIONS:
BMX Coaching Qualifications. Level:
Working With Children Check Number:
Working With Children Check Expiry:
Applicant Date of Birth:
Number of years Coaching/ Managing:
Current CPR:: YESNO
Current First Aid:: YESNO
Please provide details of Coaching/ Management experience:
Other Relevant Experience:
Referee 1:: First Name:

Last Name:
Referee 1 Mobile:
Referee 2:: First Name:

Last Name:
Referee 2 Mobile:
Supporting Written Statement:
Declaration:: I have read the role description for this position and if appointed to the role, agree to abide by the responsibilities outlined in this document
Spam Verification:

2019/2020 ACADEMY SPORTING SCHOLARSHIP PROGRAMS