Interstate Medical Personnel Application Select the Sport you are applying for*Select SportAFL 12s BoysAFL 12s GirlsAFL 15s BoysAFL 15s GirlsBasketball 12s/18s (B&G)Football (Soccer) 16s BoysFootball (Soccer) 18s GirlsHockey 16s (B&G)Netball 15s (G)Touch 12s/15s (B&G)Football (Soccer) 12sPositions*First PreferenceSports TrainerStrength & ConditioningName* First Last Are you a Registered Teacher?* Yes No School Name* School Address* Street Address City ZIP / Postal Code School Phone* Teaching History - 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 ZIP / Postal Code Work Email* Personal Email Mobile Phone* Home Phone Do you have qualifications relevant to the position? Yes No Qualification* Briefly outline your skills and attributes relevant to the position*Detail your involvement in sport at school or community level*Supply any additional information to support your applicationReferee 1*NamePositionPhoneEmailSchool Principal Permission* I understand it is my responsibility to gain approval from my school principal to particiapate in the SSWA program as an Interstate Official Upload Qualifications*Accepted file types: jpeg, jpg, pdf, doc, docx, Max. file size: 10 MB.Please upload evidence of your relevant qualifications.