Umpire Application (U18)
First Name: *
Last Name: *
Email Address: *
Mobile: *
Work Phone: *
Home Phone: *
Address: *
Suburb: *
Postcode: *
Age: *
Date of Birth:
Are you a current Primary School student?
Yes
No
Primary grade
Are you a current Secondary School student?
Yes
No
Secondary year
Umpire Minor Parent/Guardian
To be filled out by Parent/Guardian
Parent/Guardian Name: *
Relationship: *
Email Address: *
Mobile: *
Work Phone: *
Home Phone: *
Does this child reside with you?: *
Yes
No
If not, who does this child reside with?: Describe
Email Address:
Mobile:
Work Phone:
Home Phone:
Are you aware that our Melbourne High School venue has a liquor licence?: *
Yes
No
Does this child know they are not permitted under any circumstances to attempt to buy or be bought a drink containing alcohol?: *
Yes
No
Does this child know that they would be immediately dismissed if found attempting this task?: *
Yes
No
As a guardian, do you realise that the liquor licence is not owned by Melbourne Netball Pty Ltd?: *
Yes
No
Do you understand that Melbourne Netball is not legally responsible if this child does consume alcohol after their shift?: *
Yes
No
How will this child be transported to and from the different venues?: Describe
The questions below are to help us understand what information you may already know about the netball sport before we do a phone interview.
Are you a nationally badged umpire?: *
Yes
No
Have you played netball?: *
Yes
No
What age did you begin playing the sport?:
How many playing years throughout your life have you played?: Describe
When have you played netball?: eg: childhood, currently (describe)
Where have you played netball?: Describe
Have you ever umpired a game of netball before?: *
Yes
No
Describe a brief history of your roles in the sport, both as a player and umpire:
Have you ever seen a rule book?: *
Yes
No
Do you own a rule book?: *
Yes
No
What Years?:
What type of games have you umpired?: eg: primary school, secondary school, private business, Netball Victoria association etc.
How many games a week?: Describe
Have you sat a theory exam?: *
Yes
No
What year did you sit your theory exam?:
What was your resulting mark?:
Are you a nationally badged umpire?: *
Yes
No
What year were you badged?:
Have you seen a proper game of netball from an ‘A’ grade netball victoria association team, a Melbourne State Team, The Australian International Team?: * Describe
Have you attended a level 1 course?:
Yes
No
Have you attended a level 2 course?:
Yes
No
Have you controlled a game of netball on your own?:
Yes
No
Have you seen a game of mixed netball?: *
Yes
No
Have you ever umpired a game of mixed netball?:
Yes
No
Have you ever sent a player off the court?:
Yes
No
Are you a current member of Netball Victoria?: *
Yes
No
Are you currently playing in a team within our Melbourne Netball company?: *
Yes
No
If yes, Team Name:
We operate on a Monday, Tuesday, Wednesday, Thursday only. Which nights are you available for training?: *
Monday
Tuesday
Wednedsay
Thursday
How many nights are you available for training?: *
1 Night
2 Nights
3 Nights
4 Nights
* indicates mandatory field