Let’s work together.Fill out your info below to get set up and registered with us and we will be in touch shortly! Name * First Name Last Name Email * Phone * (###) ### #### Date of Birth * MM DD YYYY Gender * Male Female Prefer Not To Say Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact * First Name Last Name Emergency Contact Phone Number * (###) ### #### Emergency Contact Relationship * How is this person related to you? Spouse Parent Sibling Relative Friend Other Emergency Contact Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Boot Size AU 7 8 9 10 11 12 13 14 15 Shirt Size AU XS S M L XL 2XL 3XL 4XL 5XL 6XL USI (Unique Student Identifier) Are you an Australian Citizen? Yes No Are you Aboriginal or Torres Strait Islander? Yes - Aboriginal Yes - Torres Strait Islander Yes - Both Aboriginal & Torres Strait Islander No Do you hold a current working Visa? Yes No If yes, Visa Details: Do you hold a recent Police Check? Yes No Thank you!
