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Referees Availability | 2024 WA Junior State Championships presented by Fuel to Go & Play
Please fill out the form and provide your availability for Junior State Champs.
Event Dates: Friday 29th November, Saturday 30th November & Sunday 1st December
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1.
Please write your first name and last name
(Required.)
*
2.
Please enter your best contact details below:
(Required.)
Email Address
Phone Number
3.
If you are under 18, please provide full name and contact details of a parent or guardian:
Name
Email Address
Phone Number
*
4.
Which Affiliate will you be representing as a referee?
(Required.)
Albany
Alkimos
ARKS
Baldivis
Broome
Busselton
Carnarvon
Cockburn Roar
Ellenbrook
Exmouth
Fremantle
Geraldton
Goldfields
Hedland
ECU Jets
Karratha
Kununurra
Kwinana
Newman
Northern Districts
Northam
Peel
Perth Brothers
Rosalie
Southern Districts
Tom Price
Tompkins Park
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5.
Do you hold a TFA Referee Accreditation? If yes, which level?
(Required.)
Yes, Level 1
Yes, Level 2
Yes, Level 3
Yes, Level 4
Yes, Level 5
Yes, Level 6
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6.
Do you seek to upgrade to Lv2 or Lv3 Referee Accreditation and gain your next level at the 2024 Junior State Championships?
(Required.)
Yes
No
Not sure
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7.
Are you available on
Friday, Nov 29th from 6PM to 9:30PM?
(Required.)
Yes
No
Partially
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8.
Are you available on
Saturday, Nov 30th?
If yes, specify AM, PM or both.
(Required.)
Yes, AM
Yes, PM
Yes, all day
Not available
*
9.
Are you available on
Sunday, Dec 1st?
If yes, specify AM, PM or both.
(Required.)
Yes, AM
Yes, PM
Yes, all day
Not available
*
10.
All Accredited Referees will receive a new uniform, please provide your T-SHIRT and SHORTS size below (ie: T-shirt L12 or Medium; Shorts L10 or Men's 38 etc)
(Required.)
11.
We are going to provide some food & snacks at the event. Please list any food allergies or requirements below:
12.
Please add any comments below:
