Youth Leadership Program Nomination
Youth Leadership Program Nomination
Name
Name
*
First
Last
Email
*
Contact Number
*
What Category are you nominating under?
*
Community
School
Umpiring
What Club/School/Umpires Group are you from?
*
What is your district?
*
Claremont Tigers District
East Fremantle Sharks District
East Perth Royals District
Peel Thunder District
Perth Demons District
South Fremantle Bulldogs District
Subiaco Lions District
Swans District
West Perth Falcons District
What leadership skills do you currently display?
*
Why do you think you should be selected to participate in the Youth Leadership Program? (Max 200 words)
*
To assist in verifying your leadership qualities can you please provide the details of a referee.
The referee can be from your school (teacher or principal), Club (coach, president etc) or your Umpires Group (coach).
Name
Name
First
Last
Referee contact email or phone number