National Umpire/Measurer Application Form - Bowls SA

National Umpire/MeasurerApplication FormTICK CURRENT NOAS ACCREDITATION:NoneLevel 1 National UmpireLevel 2 National UmpireMeasurerTICK ACCREDITATION/RE-ACCREDITATION REQUIRED:MeasurerLevel 1 National UmpireLevel 2 National UmpirePlease type or print clearlyTITLE: SURNAME*: GIVEN NAMES*:ADDRESS*: SUBURB*: P/C*:HOME PH*: BUSINESS PH: MOBILE:EMAIL*:BOWLS CLUB:DATE OF BIRTH*:DISTRICT:STATE/TERRITORY ASSOCIATION (STA)*:STATE/TERRITORY AFFILIATON NUMBER:If reaccrediting, did you previously affiliate with the STA above? □ YesIf no, which STA did you affiliate with?□ NoCurrent NOAS Details (if applicable):NOAS NUMBER: BA EXPIRY DATE: / /* If you do not provide the information requested on this form, we may not be able to register you in the NOAS. If you haveany privacy concerns or would like to verify information we hold about you, please contact Bowls Australia Inc on 03 94807100.I hereby apply for Accreditation under the National Officiating Accreditation Scheme (NOAS). I have read the attached“Official’s Code of Ethics” form and agree to abide by the terms and conditions contained therein as evidenced by mysignature thereon.I acknowledge the information on this form is entered onto the Bowls Australia Inc database of registered umpires. Databaseinformation is passed on to relevant State and Territory Associations and the Australian Sports Commission. My informationwill not be used or disclosed except in accordance with the provisions of the Privacy Act 1988.SIGNATURE: DATE: / /ENDORSEMENT OF APPLICATION BY CLUBThe Committee has no reservations about the suitability of the applicant for umpiring at the level for which application ismade. The Committee will arrange opportunities for the applicant to practice and prepare for accreditation testing of practicalumpiring competence. The Committee will offer the applicant an equitable share of available future club umpiring work toassist with reaccreditation every four years. The Committee’s recommendation of this application is recorded in the Clubminute book.NAME: SIGNATURE: DATE: / /(Club Secretary)The fees payable are as follows:Umpire Registration Fee$11.00 (inc GST)INSTRUCTIONS: These forms should be completed by the applicant and the club secretary and the completed forms (withcheque made payable to the state/territory association) forwarded to the district umpires committee responsible forconducting this course. The code of ethics form is to be retained by the applicant when the application is lodged. Shouldthe candidate fail to be accredited, the Bowls Australia Inc fee will be refunded.

Assessment CriteriaTICK CURRENT NOAS ACCREDITATION:MeasurerLevel 1 National UmpireLevel 2 National UmpireTICK ACCREDITATION/RE-ACCREDITATION:MeasurerLevel 1 National UmpireLevel 2 National UmpireAPPLICANT:BOWLS CLUB: ____________________________ ________REGION/DISTRICT:__________________________DATE ACCREDITED:CLUB WHERE COURSE WAS HELD:ASSESSOR NAME:PRESENTER NAME:ASSESSMENTSSubject of Assessment Competent? Date1. Laws of the sport of bowls2. Measuring3. Planning4. Self ManagementOther requirements Produced Date1. Code of Behavior Declaration2. Evidence of OfficiatingComments:CERTIFICATIONThe above applicant has successfully completed the course of accreditation / re-accreditationas a Level 1 National Umpire/Level 2 National Umpire / Measurer (cross out status not applicable).Assessor for Region/District Umpires Committee:NAME:_____(Please print)SIGNATURE: _____ DATE: / /Region/District Umpires Committee Chairperson:NAME:_____(Please print)SIGNATURE: _______________________ DATE: / /State/Territory Umpires Committee Chairperson:NAME:________________(Please print)SIGNATURE: ________________ DATE: / /

Appendix TwoNATIONAL OFFICIATING ACCREDITATION SCHEMEThe NSO Official's Code of EthicsINDIVIDUAL AGREEMENT FORMFor accreditation or re-accreditation to the National Officiating Accreditation SchemeTO:Bowls AustraliaI, _______________________________________(your full name)Of_________________________________ ________________________(address)(suburb)_________________________________ ________________________(State/Territory)(Post Code)am seekinq accreditation / re-accreditation (please croos out one) for the following National Officiating AccreditationScheme (NOAS) qualification (please tick):Level 1 National Umpire LawUmpireMeasurerLevel 2 National UmpireLevel 3 National UmpireI agree to the following terms:1 I agree to abide by the NSO Code of ethics overleaf.2 I acknowledge that the NSO may take disciplinary action against me if I breach the code of ethics. I understandthat NSOs are required to implement a complaints-handling procedure in accordance with the principles of naturaljustice, in the event of an allegation against me.3 I acknowledge that disciplinary action against me may include de-accreditation from the National OfficiatingAccreditation Scheme.SIGNATURE: _________________________________________________ DATE: _______/______/______PARENT OR GUARDIAN SIGNATURE: _____________________________________________ (If under age 18)Please refer to the Harassment-free Sport Guidelines available from the Australian Sports Commission or contact yourNSO, if vou require more information on harassment issues.See other side of form for NSO Code of Ethics.

Page 2NATIONAL OFFICIATING ACCREDITATIONSCHEMEThe Official's Code of EthicsRationale• The National Officiating Accreditation Scheme policy is that the responsibility forthe ethical conduct of sport in Australia rest equally with:Officials, players, administrators, coaches, spectators, media, educators,parents, government, sponsors, team owners.• The duty of the sports official is to act as an impartial advisor and arbitrator ofsporting competition.• The National Officiating Accreditation Scheme policy is that this duty carries with itan obligation for the official to perform with accuracy, consistency, objectivity andthe highest sense of integrity.• The National Officiating Accreditation Scheme recognises that to preserveand encourage confidence in the professionalism and integrity of officiating,ethical behaviour must first be fostered by officials.• The National Officiating Accreditation Scheme will promote this in thewider community.Sports officials have the right to expect that:• Their health and safety are paramount.• They are treated with respect and openness.• They are appointed to a level of competition appropriate to their level of competence.• They have access to self-improvement opportunity.The National Sporting Organisation (NSO) Official's Code of Ethics• Place the safety and welfare of the participant above all else.• Accept responsibility for all actions taken.• Be impartial.• Avoid any situation which may lead to a conflict of interest.• Be courteous, respectful and open to discussion and interaction.• Value the individual in sport.• Seek continual self improvement through study, performance appraisal, and regularupdating of competencies.• Encourage inclusivity and access to all areas of officiating.• Be a positive role model in behaviour and personal appearance.