Adjudicators - List Your Details

Please enter your details (all fields marked with an * are mandatory):
 
Title (eg. Mr, Mrs, Ms, Dr) : *
First Name: *
Surname: *

Please note that your full address will NOT be displayed on your listing (only Suburb,State and Postcode).

Address line 1: *
Address line 2:
Residential Suburb/Town: *
Residential State: *
Residential Postcode: *
Contact Number: * (please don't leave spaces or use brackets)
Alternate contact number: (please don't leave spaces or use brackets)
Email Address: *

Qualifications/Industry Memberships or Affiliations (50 character max):

Where are you available to adjudicate (please select): * Anywhere in Australia  ACT
NSW - Sydney               NSW - outside Sydney
Vic - Melbourne            Vic - outside Melbourne
Qld - Brisbane              Qld - outside Brisbane
SA - Adelaide                SA - outside Adelaide
WA - Perth                     WA - outside Perth
NT                                   Tas
International

I can adjudicate these types of Eisteddfods: * dance
instrumental
speech & drama
vocal

Overview of yourself to appear on your listing (500 character max): *
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Would you like to attach a photo of yourself to your listing? * Yes (I will email a file with my photo) No Post (I will send a photo in the mail to be added to my listing)  

Would you like to attach a resume? * Yes (I will email a file with my resume) No Post (I will send a copy of my resume in the mail)  

Notes or comments to eDance Admin (250 character max) (Will NOT be displayed on your listing. For eDance use only)
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Discount coupon code: (if applicable) (case sensitive)

 
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