Albany Creek Shs Football Excellence Program Application Form
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1ALBANY CREEK SHS FOOTBALL EXCELLENCE PROGRAM APPLICATION FORM
As part of our school’s commitment to improved student outcomes and building a world class learning organisation,
Albany Creek State High School has been accredited as an Excellence School in football.
Students wishing to enrol in the Football Excellence Program must provide evidence of their ability and good
character prior to acceptance in the class. It is essential that this form is completed and signed by the student’s HPE
teacher, School football/sports co-ordinator or club coach and returned to the school by Friday 3 June 2016.
STUDENT NAME: ________________________________________DATE OF BIRTH:_______________________
Primary school: _______________________________________________________________________________
PARENT NAME: ______________________________________Signature:_______________________________
Address: _____________________________________________________________________________________
Telephone: _________________________________________Date:_____________________________________
This section to be completed by the Nominator.
I verify that ___________________________________________________________________________________
1.
Is a member of a recognised football club and is playing to a minimum of Division 1 level.
Club Name: ________________________________________________Div:___________________________
2.
Student’s football ability in the four core skill areas: (please circle 1-5 with 5 being the highest)
STRIKING THE BALL:
1
2
3
4
5
As a guide, a 5 would be
considered NPL level
RUNNING WITH THE BALL:
1
2
3
4
5
ability.
1V1:
1
2
3
4
5
ST
1
TOUCH:
1
2
3
4
5
ATTITUDE:
1
2
3
4
5
3.
Representative honours:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
4.
Additional comments:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
NOMINATOR NAME: ___________________________________________________________________________
Position held: _________________________________________________________________________________
Signed: _____________________________________________
Date: ______________________
Acceptance to the program is based on each student’s performance at the Selection Trials. All participating Year 6
students need to have the following equipment at the trials:
□
Boots
□
Primary School Sports Shirt
□
Socks
□
Bucket Hat
□
Shin Pads
□
Water Bottle
□
Training Shorts
SELECTION TRIALS:
Students wishing to take part in the selection trials need to attend the school Thursday 16 June 2016, 3.30pm
to 5.00pm. Students and Parents are to assemble at the MPC at 3.30pm.
G/Coredata/Office/Enrolments/2017
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