2008/08/20 12:38:29
   Syd Aus
   

K SAS-AU Network Application Form

KSAS-Au Membership Options 2007



Kids Safe-at-Sport Australia [KSAS-Au] is an initiative to assist Junior Sport Clubs to comply 
with their State Government Legislation on Child Protection.
 



MEMBERSHIP TYPE
ANNUAL
PER PLAYER



 A   1-10 Junior Teams$    50.00
$    1.00



 B 11-25 Junior Teams$ 100.00
$    2.00



 C 26-50 Junior Teams$ 200.00
$    3.00



 D 51-75 Junior Teams$ 300.00
$    4.00



 E 76-99 Junior Teams$ 400.00
$    5.00
 



		KSAS-Au SERVICES - Assisting your Club with eAdministration AND Sponsorship

		Who was in the team in 2002 ?  How do we get to that ground ?  Who scored the goals ?

		How do I lodge a Child Abuse Complaint ?	

			
		eAdministration - Club Sponsorship and Automated records

		The Junior Sports Information System [JSIS] will provide your Junior Sports Club
		with automated eAdministration including:

		1	electronic Membership Registration Form direct into Membership Database

		2	draft Team Allocation from Membership Registration

		3	BBQ and Net Rosters on the Internet

		4	Child Protection Records to confirm completed CPDs

		5	Child Complaints Administration Process

		6	Team Histories and Player Histories

		7	Maps to Venues

		8	Team Sponsorship from your Local Businesses


  
	
       

       

        



          *Mandatory 

          - Field must be completed


    
    
       
        Aa: ORGANISATION DETAILS		    
    
                
 *Organisation           Name:
      		                                                    
    
                
  *Short           Name: 
      		                                               
    
           ABN         (Bus Reg No):                                                
    
        *Type of Junior Club  :                                     
    
         *Main Sports Category:                                               
  
  
    
       
        Ab: ORGANISATION LOCATION		    
    
                
Room/Suite:                                  
      		               
Floor:                                  
      		               
Building:                                 
      		    
    
                
Street           Number:                        
      		               
 Street:                        
      		               
Suburb:                      
      		    
    
                
 State:                                   
      		               
*Pcode:                                   
      		               
Country:                                 
      		    
  
  
    
       
        Ab: ORGANISATION POSTAL DETAILS		    
    
                
PO           Box:                        
      		               
Post           Office :                        
      		               
Suburb:                                 
      		    
    
                
State:                        
      		               
 Postcode:                        
      		               
Country:                      
      		    
  
  
    
       
        Ad: ORGANISATION COMMUNICATIONS		    
    
                
*Telephone           Area Code:                        
      		               
*Telephone           No:                        
      		               
Free           Phone:                       
      		    
    
                
Fax           Area Code:                         
      		               
Fax           Number:                        
      		               
 Free           Fax:                       
      		    
    
                
Organisation           Web Address:  
      		               
http://                       
      		            
    
                
*Organisation           email Address:  
      		               
                        
      		            
  
  
               
    
       
        Ga: APPLICANT DETAILS		    
    
                
Title:                                   
      		               
Initials:(incl           Family Name)                       
      		               
*Preferred           Name:                      
      		    
    
                
First           Name:                        
      		               
Second           Name:                        
      		               
Third           Name:                       
      		    
    
                
*Family           Name:                        
      		               
Position:                                    
      		                              
  
  
    
       
        Gb: APPLICANT LOCATION 		    
    
                
Room/Suite:                                   
      		               
Floor:                                   
      		               
 Building:                                  
      		    
    
                
Street           No:                         
      		               
Street:                                   
      		               
Suburb:                                   
      		    
    
                
State:                                   
      		               
*Postcode:                                   
      		               
Country:                                   
      		    
  
  
    
       
        Gc: APPLICANT POSTAL DETAILS		    
    
                
PO           Box:                        
      		               
Post           Office :                        
      		               
Suburb:                                 
      		    
    
                
State:                        
      		               
 Postcode:                        
      		               
Country:                      
      		    
  
  
    
       
        Gd: APPLICANT COMMUNICATIONS		    
    
                
*Telephone           Area Code:                        
      		               
*Telephone           No:                        
      		               
Mobile:                                  
      		    
    
                
Fax           Area Code:                         
      		               
Fax           Number:                        
      		               
 Pager:                       
      		    
    
                
*Applicant           email Address:  
      		               
                        
      		      
  
  

    
       
        Sa: MEMBERSHIP OPTIONS		    
    
     
                
Membership           Type: 
      		      


       

          

        

         

            
   

        
        
Payment           Method:
 
      		       
                               
        
   

                
Payment           Amount: 
      		 
                      
      
  

          
Credit           Card Number: 
      		 
                             
    


                
Card           Expiry Date:  
      		 
                  
          
mth          
                  year             
    
                
Name           on Card: 
      		                                               
    
                
4           Digit Amex Code: 
      		                                               
  
   
	 

		Zz: FINISH	 		    
     
                       
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