TIS-PARA-001 (General EOI)

TIS-PARA-001

PARA UNIT

Expression of Interest

Athlete Details

First name *

Surname *

Gender *

MaleFemale

Preferred pronouns

Date of birth *

Are you under 18? *

Athlete email *

Athlete contact number *

Current Address *

Street address *

City *

State *

Postcode *

Parent / Guardian / Carer name *

Parent / Guardian / Carer contact number *

Parent / Guardian / Carer email *

Parent / Guardian / Carer name

Parent / Guardian / Carer contact number

Parent / Guardian / Carer email

To assist you, there is a requirement to understand your impairment. Providing this information is completely confidential. We’d really appreciate you taking the time to answer these questions.

Impairment Type *

IntellectualPhysicalVisual

Do you use a wheelchair? *

YesNo

Do you use any other sporting or mobility aids? *

Please describe your impairmentProvide as much detail as possible i.e. medical diagnosis, and/or your level of function, movement or other relevant information.

How long have you had your impairment? *

Any additional support required for athlete? *

YesNo

Additional support details *

Is your impairment congenital (from birth) or acquired *

CongenitalAcquired

Please provide additional details *Provide as much detail as possible – e.g. age acquired

Any other information feel may be relevant? *

Where did you hear about the TIS Para Unit *

Please specify *

Sporting Details

Do you undertake any additional sports? *

Please note any current classifications for Para sport *

What motivates you to pursue Para Sport *

What strengths do you believe will support you in pursuing your Para Sporting goals *

Click here to open the Paralympics Australia Impairment Mapping Tool

I consent to the TIS collecting and holding my personal information and its disclosure with potential project partners, including the ASC, Paralympics Australia, entities in the National Institute Network and National Sporting Organisations for the specified purposes of supporting my para-sport pathway engagement and progression, future talent identification research projects and other related purposes. *

I confirm the information I have provide is correct and wish to submit the expression of interest

*

Personal Information Protection Statement
Personal information, including health, performance and sensitive information will be collected from you for the purpose of undertaking the Tasmanian Institute of Sport’s activities. Your personal information will be only used for the primary purpose for which it is collected and may be disclosed to contractors and agents of the Department of State Growth, the Australian Institute of Sport, Sport Integrity Australia or any other State, Territory or national sporting organisations or affiliated bodies, and other organisations authorised to collect, store, and use it. Your basic personal information may be disclosed to other public sector bodies where necessary for the efficient storage and use of the information. Personal information will be managed in accordance with the Personal Information Protection Act 2004 and may be accessed by providing a written request to the Department of State Growth and you may be charged a fee for this service.

Tasmanian Institute of Sport
(03) 6777 2828
PO Box 93, Prospect, Tasmania 7250

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