Surf Life Saving Australia IT Systems User Account Application Form 049

Surf Life Saving Australia IT Systems User Account Application Form 049

The IT Systems User Account Form 049 needs to be completed for any person requiring access to SurfGuard or the Sport Event Management System (SEMS). Please note access requests will be actioned within 3 working days. If you have any issues with the application process please log these at https://help.sls.com.au
Branch Name - this is the branch your club is affiliated to
Eg: enter club name for club access / enter Branch name for Branch access etc
Club Name - Central Coast
Club Name - Far North Coast
Club Name - Far South Coast
Club Name - Hunter Branch
Club Name - Illawarra Branch
Club Name - Lower North Coast
Club Name - Mid North Coast
Club Name - North Coast
Club Name - South Coast
Club Name - Sydney Branch
Club Name - Sydney Northern Beaches
Service Type/s - this is the level of access allocated

Other
Account Type
Access level required
Access level required
User Agreement

Please ensure that all users who are applying for access to an SLSA system sign below.
User Name

First NameLast Name
User Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
User Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relevant SLSA Policies

By Applying for and/or using any Surf Life Saving Australia IT system you are governed by and agree to abide by SLSA Constitution, its By-Laws, Regulations and Policies including (but not limited to): 6.1 Intellectual Property, 6.2 SLSA Privacy Policy, 6.19 Terms of Use Policy, 6.20 Use of Social Media. Such policies and procedures can be viewed on the SLSQ Members Portal. It is important that you keep your login passwords to SLSA IT systems secure, you should never give out your password. Any misuse of data or systems will lead to disciplinary action.Privacy notice: the collection of the below information is necessary for the performance of SLSA's duties. SLSA may also store information from individuals for statistical and reporting purposes and as required by law. All information is handled in accordance with the SLSQ Privacy Policy. Individuals may correct or edit any of their details via Lifesaving Online or by contacting their club. SLSA Policies
SLSA Policies
I, as the User, have read the above and agree
Account and User Information
User Position / Role
User Phone Number

Area CodePhone Number
User Email
example@example.com
Account Username (if applilcable)
Start Date of Access / Deactivation Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date - If access is only required for a set period of time.

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please note your access will only be granted for 12 months and then we be required to be renewed.
Account needs access to:
Authorising Officer Details (must be Executive Committee Member)

Note: Applicants are not able to authorise their own Form 049
Authorising Officer Name

First NameLast Name
Authorising Officer Position
Authorising Officer Email Address
Authorising Officer Phone Number

Area CodePhone Number
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Surf Life Saving Australia IT Systems User Account Application Form 049

User Agreement

Relevant SLSA Policies

Account and User Information

Please note your access will only be granted for 12 months and then we be required to be renewed.

Authorising Officer Details (must be Executive Committee Member)