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About
Strategic Plan 2023-26
Associations
Board
Executive Committee
Standing Committees
Life Membership
Annual Reports & Yearbooks
Careers
Contact
Resources
Circulars & Memos
Declaration of Leagues
Forms
Policies & Documents
Rules & Regulations
Member Protection
Member Protection
Working with Children Check
Safeguarding Children
Help for Kids
Football NSW Child Protection Training Requirements
Training Courses
Anti-Doping
First Aid & Defibrillators
Mental Health & Wellbeing
Managing Poor Behaviour & Bullying
Complaints & Complaint Handling
Workplace Health & Safety
Media
Media Accreditation
Our Game Media Network
Social Media Policy
Sponsors
Football NSW Sponsors
Sponsorship Information & Enquiries
Insurance
Injury Insurance
Injury Claim Form
Top-Up Cover
Certificates of Currency
Sanction Information
Serious Injury Report
Risk Management
Injury Prevention
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NSW Football Legacy Program
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Champion of Champions
Country Cup
Junior Development Cup
Proctor Park Challenge
Sapphire Cup
State Cup
Waratah Cup
Trial Match Requests
Fixture Alterations
Football NSW Competitions Clubs Directory
Players
Players Hub
Find a Club
Talented Player Programs
Talent Support Program
Future Sapphires Program
State Teams
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Para Football
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Clubs/Associations Live Assessment Request Form
Clubs/Associations Live Assessment Request Form
"
*
" indicates required fields
Name of Association/Club
*
Venue Name of Proposed Course Location
*
Proposed Live Assessment Date
*
MM slash DD slash YYYY
Please note that Football NSW requires three (3) weeks notice to organise assessments and arrange schedules
Venue Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Contact Name
*
First
Last
Phone Number
*
Email
*
Below please list the following names of coaches requiring assessment with their FFA Numbers (Min 4 coaches, Max 6 coaches)
Name of Coach One Requiring Assessment
*
First
Last
FFA Number of Coach One Requiring Assessment
*
Email
*
Name of Coach Two Requiring Assessment
*
First
Last
FFA Number of Coach Two Requiring Assessment
*
Email
*
Name of Coach Three Requiring Assessment
*
First
Last
FFA Number of Coach Three Requiring Assessment
*
Email
*
Name of Coach Four Requiring Assessment
*
First
Last
FFA Number of Coach Four Requiring Assessment
*
Email
*
Name of Coach Five Requiring Assessment
First
Last
FFA Number of Coach Five Requiring Assessment
Email
Name of Coach Six Requiring Assessment
First
Last
FFA Number of Coach Six Requiring Assessment
Email
Please Note:
Submission of this application form does not guarantee a live assessment session, upon completion a member of the Football NSW technical team will contact you to confirm available date and further information. For further information please email Christopher Adams via
christophera@footballnsw.com.au
Δ