Season 2014/2015
Clubs Application Form
(Please fill in BLACK ballpoint pen and CAPITAL letters, or type out on computer/laptop/PC)
Club Name: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Home Kit Colour: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Away Kit Colour: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Secretary Name:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Address:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
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E-mail:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
SMS:|__|__|__|__|__|__|__|__|__|__|__|(NO SPACES PLEASE – Start with 07…..)
Assist/Alternative Secretary Name: YOU MUST PROVIDE THIS INFORMATION
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Address: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
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E-mail: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
SMS: |__|__|__|__|__|__|__|__|__|__|__|(NO SPACES PLEASE – Start with 07…..)
Name of County F.A.:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
*F.A. Registration No:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Is your Club in Local League?YES/ NO
Name of your Local League:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Which day does your Club play in Local League? SATURDAY AM / PM SUNDAY AM / PM
Address of Home Ground:
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**Telephone: |__|__|__|__|__|__|__|__|__|__|__| Mobile: |__|__|__|__|__|__|__|__|__|__|__|
Name of Person for Emergency Contact:
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
E-mail:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
SMS:|__|__|__|__|__|__|__|__|__|__|__|(NO SPACES PLEASE – Start with 07…..)
(*ALL Clubs MUST provide FA Registration/Affiliation number. Failure to do this may result in a fine. **All Clubs must provide Home Ground full details including telephone or mobile.)
Fee: £150 per team for EDF Challenge Cup competition. If you wish to participate in the League Competition (£150) as well as in the Challenge Cup/Plate Competition (£150) you only pay for £200 instead of £300.
Please Tick:
EDF North/South League Divisions:|__| (£150)
EDF Challenge Cup Competition:|__| (£150)
EDF North/South League Divisions & Challenge Cup Competitions:|__| (£200)
Please make out the Cheque/P.O. payable to “England Deaf Football”
Bank transfer wire - NatWest (England Deaf Football)
Account Number:- 61191159
Sort Code:- 60-14-55
Please use your team name as heading for the transfer so we know that your team have paid. Once you have done the bank transfer, please INFORM us at EDF on and
Closing date for the application: 31st JULY2014
IMPORTANT NOTICE
If your payment is late – your club may be subjected to penalty fine(s) for late payment as stated in EDF Rule Book. Your club may also be refrained from the EDF Cup draw until the payment is settled in full. If you are late with your payment after 31st July, your club WILL NOT be entered in the EDF Cup Draw.
EDF CUP Draw will take place on Sunday 3rd August 2013
EDF League format will be determined once all entries have been received in full. Subjected to numbers of teams, we may have ONE National league, or North/South leagues.
Please return this form to:
EDF GeneralSecretary,13 Woolmans Close, Broxbourne, HERTS, EN10 6PR.
You are also encouraged to fill this form electronically, scan and email attachment to