Club Registration Form Please complete this form to register your interest. First NameSurnameEmail*Phone NumberPlayer First Name*Player Surname*Date of BirthParent / Guardian Occupation *Current School / College/ University / EmployedCurrent ClubPlayer Level (tick all that apply)BeginnerNo Club ExperienceNo School ExperienceJunior Club ExperienceNational Schools – Age U14, U16, U18National Club – Age U14, U16National Colleges – U18BUCCJunior County Satellite or similar e.g. Leeds, Kirklees, Wakefield, CalderdaleJunior County Academy or similarJunior Regional Academy or similarCounty Divisions (Senior Local League) e.g. West Yorkshire, North YorkshireCounty League (Senior League) e.g. YorkshireRegional League (Senior Level) eg. Northern, North West, MidlandsNational Premier Clubs Division 1 – Div 2 – Div 3England Performance PathwayPreferred Position (tick all that apply)Goal Shooter (GS)Goal Keeper (GK)Goal Defence (GD)Wing Defence (WD)Centre (C)Wing Attack (WA)Goal Attack (GA)We would like to know about your playing career to date. Based on the answers above please give us more detail about where you played, who you played for and which leagues you played in. Previous experience in the England Performance Academy (tick all that apply)Level 1 – Academy U13Level 2 – Academy U15Level 3 – Academy NPLLevel 4 – England Rose Academy U17 U19Level 5 – England FuturesLevel 6 – England RosesWe would like to know about your academy experience to date. Based on the answers above please give us more detail about which academy, team name you have played in. You can provide any other comments or information here.Are you prepared to volunteer for the clubYesNoSubmit Please enable JavaScript in your browser to submit the form
