Champion sign up form

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What is your first name?

What is your surname?

What is your best contact email address?

What is your best contact number

Provide your phone number with no spaces to subscribe. For e.g +61405647345

So we can connect you with community members in your area, what suburb do you live in?

What state is that in?

ACT

New South Wales

Northern Territory

Queensland

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Victoria

Western Australia

We hate to be rude, but what is your date of birth?

dd-mm-yyyy

How do you describe your identity

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Other

Your sporting career

Now we know about your personal details, we are interested to hear about your sporting career.

What sporting club are you involved with?

In what capacity are your involved?

Board members

Club Administrators

Club volunteers

Coaches

Players

Please choose all that apply or that your would like to be updated on.

Why this program?

Awesome! Now we would like to know about your interest in our program and your career.

Tell us a little more about why you are interested in this level of membership?

Which of the following topics MOST interests you?

Leadership

Skill development

Mindset tools

Role models in sport

Mentoring

What is your current job title?

Are you interested in pursuing a career or opportunities in any of the following industries during or post your sporting career?

Accounting & Finance careers

Construction careers

Education & Training careers

Entrepreneurship careers

Healthcare careers

Not for profit careers

Other careers

Sports careers

Technology careers

Please select all that apply.

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