Shropshire female coaches networking group
Event Timing: Wednesday 17th July 2019
Event Address: Shropshire CFA, Greenhouse Meadow, Oteley Road, Shrewsbury, SY2 6ST
Contact: j.burke-martin@bham.ac.uk

Please note details collected on this form maybe shared with Shropshire FA and other FA Partners for coach development purposes only.
First Name *
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Surname *
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Email Address *
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Contact number *
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FAN Number (if you have one)
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Highest qualification held currently *
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Club name and position- please write 'no club' if you are not currently with a club. *
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Emergency name and contact number *
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Do you consider yourself to have a disability? if so please provide details.
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Ethnicity
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Images and video footage will be taken at the event and used for Shropshire FA promotional and marketing purposes. Please can you tick the box below to give permission to be photographed and/or recorded? *
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