Valleys Netball Club - New Umpire EOI
Complete this form to express your interest in joining 'Team White' at Valleys Netball Club.
This form is for umpires with at least 1 season of competitive umpiring experience. It is not to be used for Beginner umpires.
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Name *
Date of birth *
Competitive umpires must be born in 2010 or later.
MM
/
DD
/
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Parent/Guardian name/s
For umpires under 16 years
Primary email address *
Over 16 years- Umpire's email address. 
Under 16 years - Parent/guardian email address/es
Primary mobile *
Over 16 years - Umpire's mobile number
Under 16 years - Parent/guardian mobile number
Other email address
Under 16 years of age - Umpire's email address
Other mobile
Under 16 years of age - Umpire's mobile number
I have completed the Rules of Netball Exam within the last 4 years
 *
Competitive umpires MUST have a current exam certificate
Required
Rules of Netball Exam Details
Provide Exam percentage and year undertaken
I have completed the Foundation Umpire Education Course (previously known as Level 1 Umpires Course)
 *
Competitive umpires MUST have completed the course prior to the first fixture date
Required
Do you hold a current Netball Australia National Badge or an Association Umpire Badge or Award?
 *
Attach copy of certification at next step
Required
Netball Australia National Badge or Association Badge/Award details
Provide year attained and expiry date (for National Badges)
Do you hold a current Working With Children Blue Card or Exemption? *
Umpires aged 18 years and over must have a current Blue Card or exemption
Required
Blue Card details
Provide Card Number and Expiry Date
Will you be playing in a Valley Netball Club team in 2023? *
Required
Will you be coaching a Valley Netball Club team in 2023? *
Required
Please provide details of your recent umpiring experience *
Age group/s & division/s
Please confirm your general availability for fixture days *
Not including unavailability due to playing or coaching 
Required
I have read and understood the Valleys Netball Club Umpiring Policy & Essentials 2023 .

 *
Required
I undertake to -

* Be available whenever possible.

* Perform at my best each week no matter what division I am allocated.

* Notify of unavailability in a timely manner.

* Advise of any issues regarding allocations within 24 hours of roster distribution.

* Be on time for games.

* Notify the Valleys Umpiring Convenor in a timely manner if running late.

* Be willing to continue learning and improving

* Be enthusiastic!

 *
Required
Other information
Please add any information you feel is relevant
Submit
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