Registration - Team Leaders / Logistics

TEAM LEADERS AND LOGISTICS TEAM REGISTRATION FORM

PLEASE NOTE

This website has been configured for Google Chrome, Firefox and Safari. It is not configured to work with Internet Explorer or on tablets or phones. Please use one of the suggested browsers to complete this form

{"result":"fail", "msg":"Oops! An Error Occurred(001)"}

Please enter the Security Code specified in the Registration Confirmation Email sent to you

Mandatory questions are shown in red, optional questions are shown in black

CONTACT INFORMATION

What is your full name (as shown on your Passport or Official ID)

What is your preferred First Name (ie: Steve)

What is the best Telephone Number to contact you on

What is your Primary Email Address? (how best to contact you)

What is your Secondary or Back-up Email Address?

What is your Home Address (Street, Suburb, Town or City)

Address continued - State or Province, Country, Zipcode or Postcode

INFORMATION ABOUT YOUR LAW ENFORCEMENT AGENCY
(if applicable - Special Olympics team members need not answer)

Name of the Law Enforcement Agency you are employed by (Active or Retired)

What is your Work Address (Street, Suburb, Town or City)

Address continued - State or Province, Country, Zipcode or Postcode

What Rank do you currently hold?

What is your current position and assignment with the Law Enforcement Agency

Length of service with this Law Enforcement Agency? (completed years)

How much total service do you have in law enforcement? (completed years)

BACKGROUND INFORMATION

What is your Date of Birth (mm/dd/yyyy)

What is your primary language?

In what other languages are you fluent

Are you a Smoker?

What is the nearest major airport to your home?

What is your Airlines Seat Preference (Aisle, Middle, Window)

What Nationality are you?

The following questions relating to Passports are not required to be completed by Torch Runners from the United States

Do you have a current Passport? (valid until at least February 2016)

If you do NOT have a current Passport, when do you expect one to be issued?

What is your Passport Number

Where was your Passport issued (City, State or Province, Country)

When was your Passport Issued (mm/dd/yyyy)

When will your Passport expire (mm/dd/yyyy)

UNIFORM SIZING INFORMATION

How tall are you? (specify measurement - 5ft 10in or 179cm)

How much do you weigh? (specify measurement - 160lbs or 80kg)

What is your Waist measurement (specify - 38in or 90cm)

Select the size for your tracksuit

Select the size for your T Shirt

Select the size for your Running Singlet

Select the size for your Polo Shirt

Select the size for your Running Shorts

Select the size for your Running Socks