2025 WA State Team: Rowers and Coxswains

First Name*

Surname*

Gender*

Please find RA's Gender Diverse & Transgender Awareness Policy here: https://44155094.fs1.hubspotusercontent-na1.net/hubfs/44155094/RiA-Gender-Diverse-Transgender-Inclusion-Policy-FINAL.pdf

Date of Birth*

Club/School*

Are you nominating as a Rower or a Coxswain?*

Rower

Coxswain

Email Address*

Phone Number*

If you are Under 18 - Parent/Caregiver Name

If you are Under 18 - Parent/Caregiver Email

Rowers Only

Current Coach

Club Head Coach or Nationals Coach, if applicable.

Best 2024 2km Ergo Score + Approximate Date

Must have been completed in 2024.

Witnessed by:

Please enter the name of the coach who oversaw your erg

Most recent 2km Ergo Score:

Different from best - most recently completed 2km Test

Coxswains Only

Provide a Brief CV of your experience

I understand I need to submit a voice recording of a 2000m 8+ race, recorded during 2024, to stateteams@rowingwa.asn.au by 30 September 2024.

Yes

Crew Nominations

Current Weight:

(If nominating for a lightweight crew)

State Team Uniform

Zootie Size*

Polo Size*

Pant Size (Trackpants and/or Shorts)*

Recommendation: To order one size up.

Senior Crew Member White Linen Shirt

Answer this if you have nominated for a Senior crew and it would be your first appearance in that crew, if selected.You receive this the first time you make a Senior Crew.

By submitting this nomination form, you agree to comply with the policies of Rowing WA, as well as those of Rowing Australia, including the National Integrity Framework policies and the Code of Conduct.*

These are available on the Rowing WA and Rowing Australia websites.

I agree

Additional Comments

Rowing WA State Team Nomination Form

Rowers & Coxswains

Rowers Only

Coxswains Only

Crew Nominations

State Team Uniform