COACHES AND TECHNICAL ADVISORY PANEL
MEMBER NOMINATION FORM
Nominee’s postal address:
Nominee’s email address:
Nominee’s phone number:
I have provided a short biography (no more than 1,000 words): / YES/NO (delete one)
I satisfy at least one of the categories of members of this Standing Committee:[1] / [INSERT RELEVANT CATEGORY HERE]
I agree to comply with the FootballNSW Rules and Regulations (including the By-Laws) and I undertake to be bound by the Code of Conduct:[2] / YES/NO (delete one)
Nominee’s signature:[3]
Date:
Eligible Nominator 1:[4]
Name of Authorised Representative of Eligible Nominator (if applicable):
Eligible Nominator’s or Authorised Representative’s email address (as applicable):
Signature of Authorised Representative or Eligible Nominator (as applicable):
Date:
Eligible Nominator 2:[5]
Name of Authorised Representative of Eligible Nominator (if applicable):
Eligible Nominator’s or Authorised Representative’s email address (as applicable):
Signature of Authorised Representative or Eligible Nominator (as applicable):
Date:
[1] Nominated Members of this Standing Committee must meet at least one of the following requirements:
- hold an “A” license, “B” license or “C” license for coaches (or equivalent);
- hold a “goalkeeper” diploma (or equivalent);
- hold a “junior” license, “youth” license or a “grassroots” licence (or equivalent);
- coach Women’s football team in the state (at any level) or have done so in the last 12 months; or
- coach a Futsal team in the state (at any level) or have done so in the last 12 months.
[2]Before signing this form, please carefully read the Football NSW Rules and Regulations (including the By-Laws) and the Code of Conduct, which can be found on the Football NSW website under the section “Standing Committees”.
[3]Please note that you can only serve on one Standing Committee at a time. In addition, your nomination as a member of the Coaches and Technical Advisory Panel is conditional upon the following:
- you satisfying at least one of the required categories of members for this Standing Committee;
- two Eligible Nominators nominating you and both Eligible Members (or their Authorised Representatives) signing this form;
- you signing this form; and
- you lodging this form and your biography via email to by 5pmon Wednesday, 14 February2018.
[4]Eligible Nominators include Registered Participants, Association & Branch Zones, Clubs and Futsal Clubs & Centres (see the By-Laws).
[5] See footnote 4 above.