NSW State Team Nomination Form

NSW TEAM Nomination Form
Please accept my nomination for the
□ TARGET RIFLE □ F STANDARD
□ F OPEN
Name
□ FTR
_____________________
□ MATCH RIFLE
MATCH DESCRIPTION
DATE OF MATCH
_________________________________
In the position (s) of □ Captain
________________
□ Wind Coach
□ Manager
□ Shooter
NOMINATIONS MUST BE RECEIVED BY THE DUE DATE NSWRA OFFICE BY 5pm ON CLOSING DAY.
If nominations are emailed you should request Receipt of Delivery Acknowledgement.
Fax: (02) 9661 6042
Post: PO Box 386, MAROUBRA 2035 Late Nominations may not be accepted.
Surname:________________________________
Given Names:____________________________________
Street:________________________________________________________________________________________
Suburb:_________________________________
State:__________________
Postcode:____________
Mailing address if different from the above:
Street:________________________________________________________________________________________
Suburb:__________________________________
Phone:______________________(Home)
State:__________________
Postcode:____________
_______________________(Work) __________________(Mobile)
Email address, if any______________________ Date of Birth (mandatory for U25 nominations)__________________
Rifle Club______________________________________
Current NRAA Affiliate
□ Yes
□ No
ACHIEVEMENTS ONLY IN THE 5 YEARS PRIOR TO THE DATE OF THIS NOMINATION
This section has been divided into several specific parts - State Team Shooting; Australian Team Shooting;
Other Team Shooting; Individual Results. If there is insufficient space for results, please attach a summary of
additional information only for the previous 5 years. Do not attach your own nomination form that repeats information in a
different format or includes detail of results from earlier than 5 years ago. It will not be considered.
Nominees for Wind Coach should enter scores of their shooters and/or squad for each range. Attach additional
information if there is insufficient space.
STATE TEAM SHOOTING - National Teams Matches
Year City
300
600
700
900
Or
1000
Merret Coach's name & any comments
Total
Year
Coach's name & any comments
City
300
15shot
900
15shot
600
10shot
700
10shot
Or
1000
10shot
 PAGE 1
NSW TEAM Nomination Form
AUSTRALIAN TEAM SHOOTING
Year
Event
Scores
Name
_____________________
Coach's name & any comments
Apart from the above State and Australian events in which many will not have participated, consideration will be taken
into account of other team performances.
OTHER TEAM SHOOTING (include State v Rest, City V Country, DRA and Coached Club Teams)
Year
Event
Scores
Coach's name & any comments
 PAGE 2
NSW TEAM Nomination Form
Name
_____________________
INDIVIDUAL NATIONAL AND STATE CHAMPIONSHIP RESULTS
Year Event
Lead
Lead Queen's Queen's Grand
Up
Up
Score
Place
Score
Score
Place
DISTRICT ASSOCIATION PRIZE SHOOTS
Year Event
300
500
600
700
800
 PAGE 3
900
Grand
Place
Total
Comments (if any)
Place
Comments
any)
(If
NSW TEAM Nomination Form
CLUB PRIZE SHOOTS
Year Event
300
500
600
700
Name
800
_____________________
900
Total
Place
Comments
any)
(If
Add other Club scores recorded on your home range ONLY if you have not attended many State
Championships, DRA or Club Prize shoots in the past 5 years
CLUB SCORES
Year Range
Name
300
400
500
600
 PAGE 4
700
800
900
1000
NSW TEAM Nomination Form
Name
_____________________
OTHER SIGNIFICANT INFORMATION OR COMMENTS THAT YOU MAY WISH TO LIST IN SUPPORT OF YOUR
NOMINATION:
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
ASSUMING YOUR NOMINATION IS SUCCESSFUL PLEASE ANSWER THE FOLLOWING QUESTIONS IN 10
WORDS OR LESs
What do you expect to achieve in the Matches:
___
__________________________________________________________
__________________________________________________________________________________________
What do you expect to get out of being a member of the NSW Team?
__________________________________________________________
__________________________________________________________
What would you say are your greatest strengths as a team shooter?
__________________________________________________________
__________________________________________________________
What are your weaknesses as a team shooter that you would like to improve:
__________________________________________________________
__________________________________________________________
EQUIPMENT
Rifle No1
Type of Action:_____________ Type of Barrel:_____________ Number of Rounds Fired:_______
Rifle No2
Type of Action:_____________ Type of Barrel:_____________ Number of Rounds Fired:_______
Following selection by Council of the Captains, Wind Coaches and Manager, nominations for Shooters will be reviewed
and a squad shall be selected to trial for shooting positions. Note that not all nominees may be selected to trial. Dates for
this trial will be advised as soon as possible.
Final Team Members will be required to abide by the NSWRA Code of Behaviour and sign a State Team
Participant Agreement.
I have completed the above application truthfully to the best of my knowledge and ability.
Signature:______________________________________
Date:__________________
 PAGE 5