Netball WA Scholarship Application
  • Netball headshot/action shot
  • Declarations by Applicant

  • Place name in box above to show you have read the below:

    Privacy Statement and Statement of Disclosure
    The Organisation acknowledges and agrees that this Agreement and information regarding it is
    subject to the Freedom of Information Act 1992 and that the Grantor may publicly disclose
    information in relation to this Agreement, including its terms and details of the Organisation.

    You can access any information provided by you to Netball WA during standard office hours
    and updated in writing to Netball WA. All information provided on this form and gathered
    throughout the assessment process will be stored on a database that will only be accessed
    by authorised departmental personnel and is subject to privacy restrictions.

    Netball WA may wish to provide certain information to the media for promotional purposes. The
    information will only include the applicants Club and Association location and scholarship purpose.

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  • Referee Details

    Please supply at least 1 referee