FOOTBALL FUTURES APPLICATION FORM
A football club is about far more than just the players on the
pitch. A successful club needs volunteers to help with
Coaching and Working with Teams; Refereeing; Events;
Running and Developing the Game; Promoting the Game;
Respect. All these roles play a vital part in the development of
a successful club.
The Surrey County FA is committed to recruiting new volunteers
that can have a positive contribution to football in Surrey. We
have therefore set up a volunteer ‘Football Futures Programme’
which is designed to mentor new volunteers and provide them
with the skills and experience required to make a real difference.
By simply registering your details and logging your volunteer’s hours you will become
part of the Surrey County FA Football Futures Programme and as a result will be kept
up to date on volunteer opportunities local to you, together with new and existing
training courses and special offers.
In addition you will also be invited to attend the annual
volunteer’s celebration evening and will also have the
opportunity to be nominated for the annual County,
Regional and National FA workforce awards.
If you are interested in registering for the Surrey County FA ‘Football Futures’
programme please complete the application form below and start logging your hours
PERSONAL DETAILS
Name
DOB
Address
Postcode
Mobile
Home
Email
What are your main areas of interest? Please tick
Coaching
Refereeing
Events
Running and Developing the Game
Promoting the Game
Respect
Do you have any football related qualifications? Yes
No
(if yes please specify)
Name of School/College
Have you had an FA CRB check? Yes
No
If No and over the age of 18, you will be required to take one, this can be done at the
Surrey County FA headquarters in Leatherhead. To book an appointment please
contact Michelle Jeffcoate on 01372 384 747 or email
[email protected]
Please provide details of two references
Name
Name
Address
Address
Postcode
Postcode
Tel
Tel
Email
Email
SPORTS EQUITY MONITORING
Gender
Please indicate if you are Male
or Female
Ethnic Background
Please choose one category from A to E and then please tick to indicate your ethnic
background:
A) White
English
Irish
Scottish
Welsh
Other
B) Mixed
White & black Caribbean
White & black African
White & Asian
Other
C) Asian or Asian British
Indian
Pakistani
Bangladeshi
Other
D) Black or Black British
Caribbean
African
Other
E) Chinese or Other Ethnic
Group
Chinese
Other
Disability
Please mark tick if you have a disability
If you have ticked above please tick in all that apply to you below:
Visual impairment
Hearing impairment
Mental health problems
Physical disability
Learning disability