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Tasman Youth Advisory Group - Application
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* Indicates required question
Name (Full name)
*
Your answer
DOB
*
MM
/
DD
/
YYYY
Email
*
Your answer
Phone Number
*
Your answer
Gender
*
Female
Male
Your currently Rugby involvement...
*
Player
Coach/Manager
Referee
Administrator
I'm not currently involved (e.g. stopped playing this year)
Other:
Required
Overall rugby experiences. Please tick all your experiences:
*
Player
Coach/Manager
Referee
Supporter
Administrator
Played 15s
Player 7s
Played 10s
Played Rippa / Quick Rip / Touch Rugby
Other:
Required
Your current Rugby Club/School...
*
* Tasman Referee Club
* I'm not currently involved in any club/school
Awatere
Buccaneers
Central
Collingwood
Garin College
Golden Bay High
Harlequins
Huia
Kahurangi
Marist
Marlborough Boys College
Marlborough Girls College / Central Girls
Motueka High School
Motueka United
Moutere
Murchison
Nayland College
Nelson Club
Nelson College
Nelson College for Girls
Pelorus
Queen Charlotte College
Rangers
Renwick
Riwaka
Stoke
Takaka
Tapawera
Waimea College
Waimea Old Boys
Waitohi
Wanderers
Other:
What grade are you currently involved in? (2021 season)
*
U13
U14
U15
Y17
U19/20
1st 15
Senior Bs
Senior As
N/A
I'm not currently involved in any grade
What are your goals and passions in and out of Rugby?
*
Your answer
Why do you want to be a part of the Tasman Youth Advisory Group?
*
Your answer
Please supply the name and contact details of a referee to endorse your application
Your answer
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