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2027 - NT State Team Off Field Nominations OPEN
Fri 02 Oct 2026 00:00 - Fri 01 Jan 2027 00:00
TBC
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Basic details
First name*
Last name*
Phone number*
Email address*
Address*
Additional information
Full Name*
Registered Club
Banks Hockey Club
Commerce Pints Hockey Club
East Darwin Hockey Club
Nightcliff Tigers Hockey Club
Palmerston Saints Hockey Club
Waratah hockey Club
Position applying for*
Coach
Assistant Coach
Manager
House Parent (U14 only)
Selector
Stingers Academy Coach
Age group*
U21
U18
U16
U14
Interested in the following Team*
Men
Women
either
Do you have any experience*
yes
no
If yes, please specify*
Max 255 characters
Emergency Contact Name*
Emergency Contact Number*
I agree to the use of my image (i.e. photos)*
Do you have a working with Children card*
yes
no
Please advise expiry date and Notice No*
I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*
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