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* 1. Applicants Full Name

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* 2. Applicants Mobile Number

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* 3. Applicants Home Club

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* 4. Applicants Email Address

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* 5. What is your KOMP ID?

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* 6. Applicants Level of Officiating Reached

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* 7. Please provide a short summary of your officiating experience including the roles you have performed, the events you've officiated at and the number of years you have been officiating.

Co-Funding Amount

Karting Australia will provide a co-contribution of $750 to successful applicants.
Applicants are expected to secure matching co-funding of $750, which may be sourced from one or more of the following:
  • Their State Association
  • An Affiliated Club
  • A personal contribution
  • Third-party support, such as a sponsor or local business
Evidence of confirmed or committed co-funding must be included with the application.

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* 8. Did you apply to your State Association for co-funding?

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* 9. Please attach evidence of confirmed or committed co-funding.

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1. I am duly authorised by the organisation to prepare and submit this application.

2. The responses in this application and all supporting documents provided are to the best of my knowledge, true and accurate.

3. I understand that information in relation to this application may be made public.

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* 10. By completing the details below you are "signing" the Applicant Declaration

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