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First name

Middle name

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Address

Suburb/town

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Mobile phone

Alternate email

General

Date of birth

Day Month Year

Gender

AFL team you support

How many matches of the 2020 AFL Home and Away Premiership season did you attend live in person?

Either parent from Aboriginal and/or Torres Strait Islander Origin

Were any of your parents born overseas?

Country of Birth

Country of Birth (Mother)

Country of Birth (Father)

Have you been convicted of or are you currently charged with a criminal offence?

I am employed or involved at a VFL, VFLW and/or NEAFL Club

Do you identify as living with a disability/disabilities?

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Please provide us with additional information around how we can best support you in your disability/disabilities (optional)

Communication Preferences

I would like to receive the monthly CoachAFL Newsletter

I would like to receive communications and special offers from Australian Football Bodies and on behalf of selected partners

Coaching Interests

Team age (or closest to) that you are most interested in coaching?

Coaching

Number of teams I'm coaching in 2021

Coaching Role 1

I'm currently coach at a...

Coaching Role

State

League/Region

Club

State

Country

School

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Team age

Team gender

Coaching Role 2

I'm currently coach at a...

Coaching Role

State

League/Region

Club

State

Country

School

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Team age

Team gender

Coaching Role 3

I'm currently coach at a...

Coaching Role

State

League/Region

Club

State

Country

School

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Team age

Team gender