Volleyball England

/

Volleyball England

COACH REGISTRATION

Member Details

1st August 2016–31st July 2017

/
First Name: / Surname:
Address 1: / Address 2:
Address 3: / Town:
County: / Postcode:
Tel. Home: / Tel. Work:
Mobile: / E-mail:
D. O. B: / Gender: Male / Female

Volleyball Englandsupports the principle of equal opportunities for all participants, member, representatives and employees whilst working for, or on behalf of Volleyball England. Volleyball England opposes all forms of unlawful and unfair discrimination on the grounds of age, colour, race, nationality, religion, ethnic or national origin, gender, marital status, sexuality, HIV status, disability or unrelated criminal convictions.

EthnicityPlease indicate
White - British / White – Irish / White - Other
Asian – Indian / Asian - Pakistani / Asian – Bangladeshi
Asian – Other / Chinese / Mixed – White & Black Caribbean
Mixed – White & Asian / Mixed – Other / Black – Caribbean
Black – African / Black – Other / Other Ethnic Group
If you have indicated White-Other, Asian-Other, Mixed-Other, Black Other or Other Ethnic Group please state:
Highest Participation Level of Coaching Please indicateone only
NVL / Regional / Local League
Junior/School League / Recreational
Participation Frequency of Coaching Please indicate
Not in previous 12 months / Once in previous 12 months
Once a month in previous 12 months / Once a week in previous 12 months
3 or more times a week in previous 12 months
Age Band Please Circle if D.O.B. not disclosed
Under 16 / 16-19 / 20-24 / 25-29 / 30-34 / 35-44 / 45-64 / 65+
Disability Please indicate
Long term illness or health problem that limits activity / Disability that restricts the sort of activity in which you participate
Please enter the details that you wish to be displayed on the Volleyball England Website search facilities and membership reports
(by entering details here you give permission for these details to be displayed on the Volleyball England website and included on membership reports that may be sent to members and public enquirers)
Public Telephone / Public E-mail
/

Volleyball England

COACH REGISTRATION

Coach Details

1st August 2016 – 31st July 2017

/

Please complete in as much detail as possible and in BLOCK CAPITALS 

New Registrations - Please advise us of the qualifications you hold and certificate date – this is important to enable us to process your registration promptly. Please also ensure you send a passport photo with your application. Without this, we cannot provide you with a membership card.
Qualification (Level) / Certificate Date / Name of Tutor
Please return this form, the appropriate fee, together with one passport sized photograph, to the address given below
Re-Registrations
Please return the registration form and registration fee to the address given below.
*Please note that renewals can be completed by logging on to the Member Services section of the Volleyball England website*
Please  if you Coach players under the age of 18

In line with the requirements of the Volleyball England Child Protection Policy, all individuals working with or involved with junior participants will be required to complete a Disclosure and Barring Service(DBS) check.

Which forms of the game do you coach, please circle / Beach / Indoor / Sitting
At which Volleyball Club do you coach?
Do you coach Volleyball as a teacher or at a HE or FE institute?
If so, please state which institute
If you are a Coach for an NVL Team please state name of team(s) and division(s)
Division / Team Name
Average No. of Hours per week you provided coaching for over the past 12 months
(Please Circle) / 0-2 / 2-4 / 4-6 / 6+
REGISTRATION FEES: Please make cheques payable to English Volleyball Association Ltd
Qualified Coach / Standard rate
£38.00
Qualified Coach with The Art of Coaching Volleyball – Premium membership / £50.00
Dual registration as a VOLLEYBALL ENGLAND COACH AND REFEREE entitles you to a £10 discount off the total fee (Registration must be simultaneous)

Data Protection: Any information provided by you will be held centrally by Volleyball England on its computer databases and by Volleyball England commissions and regional officers and used for administering your involvement in volleyball. Data may be passed to authorised data processes and used for this purpose.

• If you do not wish any of your details to be disclosed to members or public enquirers please tick this box ☐.
• We will from time to time contact you by telephone, email or other electronic means to promote Volleyball England products and services. If you do not want to receive these communications please tick this box ☐.

PLEASE NOTE: This will mean you will NOT receive the monthly e-newsletter or any other promotional communication from Volleyball England including information on events and competitions.

• We may from time to time pass your information on to carefully selected partners. If you do not want your details passed on to Volleyball England partners please tick this box ☐.

I agree to be bound by the Code of Conduct for Coaches (Available on the Volleyball England Website) & accept the authority & jurisdiction of Volleyball England.
Signed: / Date:

Volleyball England

SportPark,LoughboroughUniversity,3 Oakwood Drive, Loughborough. LE11 3QF

Tel: 01509 227722 Fax: 01509 227733 E-mail:

Website:

Registered in England number 2023635