» Coach Endorsement Application

Are you registering as a/an ?*

School Employee / Teacher
Private Coach
Association/Club Coach

How would you like to be endorsed as a teacher?*

Only to teach softball at the school i currently work in
To be able to coach at other schools
At both the school i teach at as well as external education intitutions
Unsure - Please contact me regarding this

You can select more than one option.

State:*

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Association:*

Member of:*

Bandicoots
Dragons

Member of:*

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Name of Private Provider:*

Association:*

Member of:*

Member of:

Dubbo City Softball Club
Others

Member of:*

Auslec Hurricanes
Baseballers
Enzed Konnectors
Jaguars

Member of:*

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Assocaition:*

Member of:*

Norths
Raiders
Storms
Truckies

Member of:*

Barramundi's
Wanderers

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Name of Private Provider:*

Association:*

Member of:*

Misfits
Sloggers
Terrors

Member of:*

Dragons
Hawks
Mackay
Misfits

Member of:*

Aztecs
Inacs
Sparx

Member of:*

Pirates
Rebels
Red Devils
Wanderers

Member of:*

Dodgers
Redsox
Slammers

Member of:*

Bluebirds
Frenchville
Magpies
Outlaws

Member of:*

Dodgers
Griffith University
Redbacks

Member of:*

Bandits
Redbacks
Stingrays
Swingers

Member of:*

Brisbane Giants
Marist
Springwood
Tan

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Name of Private Provider:*

Association:*

Member of:*

Bandits
Rays
Sharks
Tigers

Member of:*

Demons
Warriors
Wanderers
Concordes

Member of:*

Demons
Phontoms
Hornets
Hillbillies

Member of:*

Checkmates
Cougars
Solly Cats
Tigers

Member of:*

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Association:*

Member of:*

Bears
Legends
Panthers
Raiders

Member of:*

Eagles
Saints

Member of:*

Central Bears
Eastern Lightening
Raiders

Member of:*

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Private Provider if not in list:*

Kelly Sports Office / Franchise:*

Gecko Sports Office / Franchise:*

Association:*

Member of:*

Craigieburn
Comets
Melbourne Pirates
Metrans

Member of:*

Cheetahs
Monarchs
Rebels
West Coburg Redbacks

Member of:*

Goonawarriors
Jackson Panthers
Sherwood Knights

Member of:*

Invoicing on my behalf - NSO, SSO, Association*

Private Provider managing my programs:*

Name of Private Provider:*

Association:*

Member of:*

Bunbury Tigers
Leschenault

Member of:*

Crusaders
Oldies

Member of:*

Bedford Invasion
Southside Mariners
Vikings

School Name:*

School Address*

Street Address Address Line 2 City State Postcode

PERSONAL INFO:

Name:*

First Last

Email:*

Phone:*

Address:*

Street Address Address Line 2 City State Postcode

DOB:*

Gender*

PLEASE PROVIDE:

Current Employee Working with Children Check relevant to the state sessions will be conducted:*

Coaching General Principles and/or accreditation in another Sport:*

Softball Australia Coaching Accreditation – Online Induction or higher:*

I AGREE TO:

Complete all requirements to become officially endorsed to conduct Softball as part of the Sporting Schools Program
Conduct all sessions in line with the Softball Batter Up (SBU) Softball Australia endorsed program
Run all programs in line with Australian Sports Commission (ASC) and Softball Australia requirements for the Sporting Schools Program
Inform your organisation of any changes to programs being delivered
Any concerns with duty-of-care will be reported to your organisation and/or Softball Australia
Conduct all programs in a professional manner

I agree to:*

I agree

Name*

First Last