WEST RIDING COACHES ASSOCIATION APPLICATION FORM


NAME....................................................................................................

ADDRESS..............................................................................................

............................................................                 POSTCODE..................

TEL (Day) .............................                         TEL (Eve)  ..............................

E-MAIL..................................................................................................

CURRENT COACHING ROLE...................................................................

CURRENT FA QUALIFICATIONS...............................................................

ETHNICITY (Please Tick)

White
Irish
Black African
Black Carribean
Black Other
Indian
Pakistani
Bangladeshi
Chinese
Other

Payment Enclosed         £...................................

I hereby apply to join the West Riding Coaches Association and enclose the appropriate fee (cheques / postal orders made payable to West Riding County FA).
I understand  that West Riding County FA and their servants, agents and employees are not under any liability whatsoever in respect of personal injury, loss or damage however caused, while taking part in any activities of the Association.


SIGNED.................................................              DATE    ....../....../...........

Please complete and return to:
Coaches Association, Football Development,
WRCFA
Fleet Lane
Woodlesford
LEEDS
LS26 8NX