Coaching Registration 1Applicant Details2Sporting Achievement Details3 HiddenGroups* Coaching First Name* Family Name* Email* Enter Email Confirm Email Street Address* Town* Postcode* Date of Birth* DD slash MM slash YYYY Gender* Male Female Gender Neutral Home Phone Mobile Phone* (athlete)ATSI-Diverse Background (Optional): Yes No Are you of Aboriginal and Torres Strait Island background? This information is used for NCAS and NSW Government - Office of Sport reporting requirementsCALD - Culturally and Linguistically Diverse (Optional): Yes No Are you of a culturally or linguistically diverse background? This information is used for NCAS and NSW Government – Office of Sport reporting requirementsHome Club & Association* Membership Number* e.g. Netball NSW / Basketball NSW / Golf Link etc. Selection CriteriaIn the boxes below, please specifically and accurately respond to each of the selection criterion. This will enable the selection panel to accurately assess your application.Which sport are you applying for?* AFLW Basketball Cycling Golf Golf Development Hockey Netball Netball Umpires Swimming Volleyball Which position are you applying for?* Head Coach Assistant Coach Umpire Coach Satellite Coach Apprentice/Trainee Coach Specialist Coach Manager Do you hold a current coaching accreditation with a registered State Sporting Organisation?* Yes No Coaches are required to hold a minimum level 1 coaching accreditation and be a current membership of your association.SUCCESS IN COACHING*Please detail: • Placings in competitions of teams/athletes/umpires you have coached in the past 3 years. • Improvement over these years. • Achievements and development of individual athletes/umpires (Representative teams, Academy programs, school programs etc.) COMMITMENT TO PERSONAL EXCELLENCE AND GROWTH - ongoing education, reflection and innovation*Please detail: • Education and accreditation programs you have undertaken through your State Sporting Organisation and other. (EG Connect & Learn, Net Ed, Hockey Ed, accreditation etc.) in 2020 and 2021. • Innovations you used in your coaching. • Examples of self- reflection and utilization of mentoring in coaching. DEDICATION TO THE CARE AND INDIVIDUAL DEVELOPMENT OF ATHLETES*Briefly describe: • An example of how you have influenced the growth of an athlete/umpire. QUALITIES YOU BRING TO THE PROGRAM* If you wish to provide additional information not covered with your above responses, please include them in the section below.DocumentsPlease provide the following supporting documentation.Working With Children Check number* Coaching Accreditation Certificate*Max. file size: 8 MB.Current First Aid Certificate (HLTAID003)Max. file size: 8 MB.Current CPR Certificate (HLTAID001)Max. file size: 8 MB.Swimming Australia Safe Sport CertificateMax. file size: 8 MB.This is required if you are applying for a coaching position within the NCAS Swimming Program.Sport Integrity Australia Level 1 Anti-Doping CertificateMax. file size: 8 MB.Sport Integrity Australia was formerly known as ASADAProfile Picture*Max. file size: 8 MB.Must be a recent high-quality head and shoulders photo.RefereesPlease provide two referees that the selection panel can contact to support your application.Name* Contact Number* Email* Name* Contact Number* Email* Coach Declaration & ConsentCoach Declaration* The information I have provided is accurate and correct. Coach Agreement* By completing and signing the Coaching Agreement, you are confirming your participation in the NCAS Program, including attendance at all scheduled program events. CommentsThis field is for validation purposes and should be left unchanged.