Exit this survey

This form is an Expression of Interest for officials to take part in the 2014 AER Australian Championships, Brisbane 17-21st September 2014. Please read and complete each question carefully, making sure all information is accurate. Please note officials will be required to pay half of their travel and accomodation costs for this tour. Chaperones will be self funded. Thanks

Question Title

* 1. Position on Tour

Question Title

* 2. FULL LEGAL NAME - This must be the name that appears on the passport

Question Title

* 3. Preferred Name - If different from above

Question Title

* 4. Physical Address

Question Title

* 5. Email Address

Question Title

* 6. Mobile Phone Number

Question Title

* 7. Home Phone Number - Please include area code

Question Title

* 8. Work Phone Number - Please include area code

Question Title

* 9. NZ Passport Number

Question Title

* 10. NZ Passport Expiry Date

Date

Question Title

* 11. If you have don't hold a NZ Passport, please add the name of the country you hold a passport for, along with the passport number.

Question Title

* 12. Non NZ Passport Expiry Date

Date

Question Title

* 13. Club Name

Question Title

* 14. Previous tour experiences

Question Title

* 15. Consent - By ticking this box you are agreeing to GymSports New Zealand Terms and Conditions.

Please see the overseas Tour Policy for further information.

If you have any further questions, please contact Katie Dee (Vulinovich) on overseas.tours@gymsportsnz.com

Question Title

* 16. Today's Date

Date

T