First Name required

Surname required

Date of Birth (DD/MM/YYYY) required

Gender required
Please Select Female Male

Address required

Suburb/Town required

Postcode required

Home Phone required

Athlete Mobile Phone required

Athlete Email required

First Name required

Surname required

Relationship (i.e. Mother) required

Work Phone required

Mobile Phone required

Email required

Allergies required

Doctor required

Doctor Phone required

Health Fund

Health Fund Number

Medicare Number required

Medication

Medical Operations

Club

Coach required

Batting Hand required
Left Right

Bowling Hand required
Left Right

Are you a wicketkeeper? required
Please Select Yes No

Practice Schedule for past 12 months required

Your results in Cricket (National, State, and Club) required

Results in Other sports, if not Cricket required

Club games played required

Club batting average required

Club bowling average required

Club bowling aggregate required

Representative games played required

Representative batting average required

Representative batting aggregate required

Representative bowling average required

Representative bowling average required

Player type required
Top order bat (1-3) Middle order bat (4-6) Lower order bat (7-11) All rounder Fast bowler Change bowler Leg spin bowler Off spin bowler

What do you believe you can offer theIAS BlueScope Steel Cricket Program ? required

What do you believe the IAS BlueScope Steel Cricket Program can offer you? required

Write a brief summary of your goals and expectation both in Cricket and personal achievement

Athlete: I am applying for a position in the IAS 2012 Cricket Program. I certify that all information supplied herein and in any attachments is true and correct. If selected, I agree to fulfill all obligations to the IAS program. required
I agree and wish to nominate I do not agree

Parent/Guardian (if under 18): I give permission for my child to apply for an IAS Cricket Scholarship and attend any selection trials. required
I agree I do not agree

I have read and understand the "IAS Guide to Athlete Commitment" required
Yes No