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IMP Application 2021
Applications for the 2021 IMP Squad is now open.
Step 1 of 3
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Personal Particulars
Name
*
First
Last
Applicant's name
Gender
*
Male
Female
Gender Diverse
Gender
Applicants must be aged from 18 to 30 years on 7 November 2021? Do you fall within this required age range?
*
Yes
No
Date of Birth
*
Date Format: DD slash MM slash YYYY
Deadly Running Australia
If you are older than 30 on 7 November 2021, you will not be eligible to apply for IMP 2021. If you are younger than 18 on 7 November 2021, we encourage you to apply in the 2022 round of applications.
Whether you're younger or older than the required age range, we encourage you to stay involved and suggest joining a Deadly Running Australia group. Visit http://www.imf.org.au/deadly-running/ or email: deadlyrunning@imf.org.au for more information.
Mobile
*
Email
*
Enter Email
Confirm Email
Address
*
Street Address
Suburb / City / Town / Region
State
Post Code
Post Photo
Please upload a recent photo of you.
Do you identify as an Aboriginal and/or Torres Strait Islander?
*
Yes
No
If you answered YES, please list your heritage here
Getting to know you
Do you know anyone who has been part of previous IMP squads?
Yes
No
If you answered YES, please list them below.
Are you a Deadly Runner?
*
Yes
No
If you answered Yes, please list which Deadly Running Group you attend below.
Are you currently employed?
Yes
No
Why do you want to be part of IMP 2021?
*
Do you have any leadership experience or experience in health promotion?
Yes
No
If you answered YES, please list your experience below.
What is your sports/running experience?
It is important that you have support from someone in your community who will keep you motivated, help with your training and be on hand to liaise with IMP staff. Please provide details of that person.
Name
First
Last
Phone/Mobile
Relationship to you
Assistance they can provide
Health History
Do you smoke?
*
Yes
No
Do you have a current passport?
*
Yes
No
Have you travelled overseas before?
Yes
No
Do you have or have ever had any of the following health issues? Please tick whichever applies.
Diabetes
High Blood Pressure
Chronic Fatigue
Heart Disease
Mental Health Issue
Do you have any injuries or disabilities that may prevent you from running? If Yes, please provide details below.
Permission
There are some offenses that prevent entry to USA. Do you have any criminal history/record?
*
Yes
No
Any Comment?
Do you give IMP permission to provide your details to local media outlets who may wish to conduct interviews during the application process?
*
Yes
No
If you answered YES, please discuss these at the interview.
You will need to attend the try-outs in early 2021. At the try-outs, men will need to run 5km and women 3km. You will also do an interview. Are you prepared to do this?
*
Yes
No
If you answered NO to the above question, please provide details below.
Name
This field is for validation purposes and should be left unchanged.