"*" indicates required fields EmailThis field is for validation purposes and should be left unchanged.School InformationFull School Name*Principal's Name*HOLA's Name*HOLA's Email* Country Week Coordinator's Name*Country Week Coordinator's Mobile Number*Country Week Coordinator's Email* Years of attendance at Country week [including this year] [person - not school]*Total number of students attending Country Week*Males*Female*Other*Total number of staff attending Country Week*Perth Team AccommodationResidence in Perth*Address*Phone Number*Coach and Manager DetailsIndicate the teams you have nominated and complete the Coach/Manager details* Badminton Basketball Boys Basketball Girls Dance Football [AFL] Boys Football [AFL] Girls Hockey Boys Hockey Girls Indoor Cricket Netball Soccer Boys Soccer Girls Speech and Debating Touch Volleyball Boys Volleyball Girls Name - Badminton Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Basketball Boys Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Basketball Girls Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Dance Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - AFL Boys Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - AFL Girls Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Hockey Boys Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Hockey Girls Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Indoor Cricket Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Netball Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Soccer Boys Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Soccer Girls Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Speech and Debating Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Touch Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Volleyball Boys Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Name - Volleyball Girls Coach/Manager* First Last Mobile Number*Number of years attending Country Week?*Other InformationEducation Region*South MetroNorth MetroGoldfieldsKimberleyMidwestPilbaraSouth WestWheatbeltUnknownEducation Sector* Department of Education AISWA CEWA School Type* Government Non - Government GenderNumber of students if known.Male*Female*Gender DiverseEthnicityNumber of students if known.Aboriginal and/or Torres Strait Islander*Cultural and/or Linguistic Diversity (CaLD)*Includes students who speak another language at home; where English is their second language; whose parents were born overseas.DisabilityStudents With A Disability*If known this includes students with a diagnosed physical, intellectual, sensory or social & emotional disability.Team CaptainsBoyGirl Add Remove
