THE SOUTH WALES FOOTBALL ASSOCIATION LTD
Form ‘R’
APPLICATION FOR REGISTRATION FOR REFEREE – SEASON 2015/2016
REFEREES MUST NOT REGISTER WITH ANY LEAGUE UNTIL THEY HAVE REGISTERED WITH THIS ASSOCIATION A REFEREE WHO OFFICIATES IN UNSANCTIONED FOOTBALL WILL HAVE HIS REGISTRATION CANCELLED WITH IMMEDIATE EFFECT
PLEASE COMPLETE IN BLACK INK AND BLOCK LETTERS
PARTICULARS OF REFEREE:
Surname: / Forenames:Date of Birth: / Age: / Class: / Reg. No.:
Full Postal Address:
Post Code:
*Home Tel No.: / *Mobile No:
*Please confirm which number you prefer to feature in the Handbook
Email Address:
FAW D & BS Disclosure No.: / Expiry Date:
Which Referees’ Society are you an active member of?
Which League do you intend to officiate in?
Do you have access to your own transport?
NB: A Referee cancelling an engagement without the authority of the original appointer for the purpose officiating in another match shall be dealt with by this Association for breach of contract.
All disciplinary reports must be sent to this Association only.
Any Referee found guilty of misconduct shall be liable to have his name removed from the register.
Your Receipt No. will be required by a League when registering for Season 2015/2016.
REFEREES ARE INSTRUCTED THAT THEY ARE ONLY ALLOWED TO WEAR BLACK KITS (UNDER F.A. OF WALES INSTRUCTIONS).
IF YOU WISH TO BE CONSIDERED FOR PROMOTION PLEASE TICK THE RELEVANT BOX
GRADE 4B TO 4A GRADE 4A TO 3B
ALL REGISTERED REFEREES OFFICIATING IN APPROVED COMPETITIONS ARE COVERED BY PUBLIC LIABILITY INSURANCE
I enclose cheque/postal order value £10 made payable to the South Wales F.A. Ltd being Registration Fee for Season 2015/2016.
This form, when properly completed, must be returned to the General Secretary of the Association, 24 Ty Crwyn, ChurchVillage, Pontypridd CF38 2HX not later that 30th June 2015, failing which membership will lapse and a double fee of £20 shall then be paid for membership.
(N.B. THIS RULE WILL BE APPLIED STRICTLY)
A Referee must be registered with the Association within whose area he resides, and subject thereto, he may be registered with any other Football Association on payment of the fee fixed by such Association.
WARNING:A REFEREEE IS NOT PERMITTED TO OFFICIATE IN A LEAGUE IF HE IS A MEMBER OF THAT LEAGUE MANAGEMENT COMMITTEE.
Signature of Applicant: / Dated:(IN ACCORDANCE WITH AND ACCEPTING THE RULES & REGULATIONS OF THE FOOTBALL ASSOCIATION OF WALES AND THE SOUTH WALES FOOTBALL ASSOCIATION LIMITED.)
FOR OFFICIAL USE
CLASS: / REG NO: / RECEIPT NO: / REG DATE: