FA Coaching Association App Form

FACAThe FA Coaches Association

Application Pack

To be a FACA member you must hold an FA CRB Enhanced Disclosure.To receive your CRB form call 0845 210 8080

You’ve got the skills, now join the club

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The FA Coaches Association

A personal invitation to join the world’s best coaches’ association

Firstly, congratulations on achieving your latest FA coaching award.

Now, armed with this qualification, you are eligible for membership of The FACoaches Association (FACA) – and we encourage you to join as soon as possible.

Why?Because your coaching career shouldn’t stop here, and FACA can play a huge rolein developing your skills – to your benefit and those you coach.

How?• By giving you instant online access to an unrivalled archive of coaching tips,practices and interviews with some of the game’s top practitioners

• By allowing you access to the most comprehensive suite of free coachingdevelopment days across our network of County FA’s working with qualified FA staff

• By putting you in contact with the local and regional FA coaching support staff• By keeping you up to date with coaching vacancies, events and networkingopportunities both through our exclusive website FACA Live and through theFACA journal ‘Insight’, sent three times a year

There are lots more tangible benefits of FACA membership – all listed in thisleaflet – and one key intangible one:

Irrespective of the level at which you coach, FACA membership shows you’reserious about coaching, and tells your players, their parents and your colleaguesthat you aim to continuously improve. You’ll be telling your players thesemessages week-in, week-out!

So why wait? Join today and open the door on the coaching world

More about FACA:

The FA Coaches Association (FACA) is the only recognised membership clubdesigned to support the continued development of all FA qualified coaches inEngland, at all levels of the game.

Launched in 1997, FACA has recently been revamped to build and improve uponits original principles: ‘to positively affect the attitudes, ethics, knowledge andperformance of football coaches’.

The various membership benefits are all designed to support this central goal.

Whatever you want to be in football, there’s an FA Learning course for you – coming soon in your County: Coaches: Introductory, advanced and specialist qualifications Referees: Basic and advanced courses Medics: Medical and exercise science courses Administrators: Online courses Tutors: Training and development Welfare Officers: Safeguarding Children and Welfare Officer workshops County FA staff, Charter Standard League and Club Officials: Race, Disability and Equality workshops. Plus an ongoing series of events and conferences.

/FALearning0870 850 0424

WANT TO LEARN MORE ABOUT FOOTBALL?

OF COURSE WE HAVE A COURSE.

Membership benefits:

Free online access to the world’s mostcomprehensive coaching archive‘FACA Live’, provides all FACA memberswith 24/7 access to an exclusivewebsite which contains:• Monthly video/audio streamedinterviews with professionalmanagers and coaches

• Weekly email updates containingcoaching vacancies, news and events.

‘FACA Live’ can be subscribed toseparately from FACA membershipat £27.50 per year, but it’s free to allFACA members.

Three copies per year of ‘Insight’Like any professional body, FACA hasan official journal. Produced three timesa year, ‘Insight’ is mailed directly to yourhome. Its 50 plus colour pages containnumerous high-quality coaching-relatedarticles, news and views from some ofthe world's top coaches, as well asmany practical coaching hints and tips.

Free Access to Continual ProfessionalDevelopment (CPD) OpportunitiesWith a growing staff of national andregional FA Coaches, FACA memberscan attend free coaching events at localCounty FA’s as part of the requirementto retain and refresh qualifications. TheFA Coaching Development Days takeplace in every County FA with morethan 200 free events for you to attendeach year.

Insurance Cover - £5m Civil LiabilityInsurance ProtectionHaving adequate insurance coveris vital for every coach. FACAmembership covers insuranceprotection encompassing:• liability to any third parties includingplayer to player actions, and legaldefence costs

• Worldwide cover• Libel and slander cover• Errors or omissions in instruction,advice or treatment – evendietary advice

• No age limit

Insurance Cover - Personal AccidentInsurance ProtectionThis is included for all members up tothe age of 65, in case of an accident thatoccurs whilst participating in any footballcoaching or associated activities.Cover includes:• Permanent Total Disablement fromgainful employment £50,000

• Loss of limb(s) and sight of eye(s)£50,000

• Death: £50,000Full policy details supplied upon writtenrequest. (In all cases the policy wordinghas precedence over above information).

Coaches operating under a tradingname are not covered by the FACAinsurance. Cover may be obtained [email protected] or bytelephoning Perkins Slade Ltd on0121 698 8000.

Discounts on FA CoursesFACA members enjoy substantialdiscounts on all courses in The FANational Courses programme. Coursesinclude the UEFA ‘B’, ‘A’ and ProLicences, Youth Coaches Courses,Academy Manager Courses, as well asour range of sports medicine, exercisescience and sports psychology courses.

For more information on our range ofcourses visit TheFA.com/FALearning

Exclusive FACA merchandiseAll members have the chance to buybranded merchandise so that all theplayers, parents and fellow coaches cansee you’ve taken the extra step tobecome a FACA member.

Membership Pack:When you join FACA, you’re sent amembership pack which includes:• Membership Card and brandedlanyard so you can wear yourFACA card when coaching

• The most recent copy of ‘Insight’• FACA-branded mouse mat

Let’s make football safe – not sorry

Before you join FACA, you musthave an Enhanced FA CriminalRecords Bureau (CRB) check andbe ‘approved’ to work in football.

If you haven’t already beenthrough the process, don’t worry.It’s simple, non-intrusive andensures we can all play our part inproviding a safe and fun-filledfootball environment, particularlyfor children and young people.

Increasingly, parents and carers areasking if coaches have been CRB-checked and FACA membershipimmediately answers the question,as you cannot be a memberwithout a CRB check in place.

It is critical that coaches gothrough the CRB process now.As we move forwards newlegislation will ultimately meanthat it will be illegal to workwithout having gone through thevetting process.

You can request an FA CRB formas part of this application.

Support and guidance on theprocess can be gained fromwww.TheFA.com/CRB as well as [email protected] and 0845 210 8080

Full FACA Member

To become a Full FACA Member you must:• be at least 16 years of age and aUK resident

• be able to provide evidence that youhave at least one of the belowFA qualifications

• have an accepted ‘Enhanced FACRB Disclosure’

Qualifications that can be used tosecure full membership include:• 1st4sport Level 1 Certificate inCoaching Football (Club Coach)

• 1st4sport Level 2 Certificate inCoaching Football or FA CoachingCertificate

• 1st4sport Level 3 Certificate inCoaching Football or FA CoachingLicence / UEFA 'B' Award

• UEFA 'A' Licence or FA AdvancedCoaching Licence

• UEFA Pro Licence Coaching Award• FA Coaching Diploma• FA Goalkeeping Coaching 'A' Licence• FA Goalkeeping Coaching 'B' Licence• FA International Coaching Licence• FA Intermediate Award

Membership fee: from £39.50 a year

Membership Categories

There are two membership categoriesof FACA:

• Full FACA MemberThis entitles you to all the membershipbenefits outlined in this leaflet

• Online FACA memberPlease see opposite page formembership benefits

Online FACA Member

Becoming an online member of FACAmeans you can still stay up to date withall the latest coaching news.

It’s ideal for coaches who are:• Working towards their first qualification• Living outside the UK

Online FACA members receive:• 24/7 access to ‘FACA Live’• The Insight journal three times a year• Weekly FACA email updates

Membership fee: £27.50 per year.Visit http://facalive.thefa.com to register.

Please note: Online membership doesnot offer the benefit of FACA Insurance.

Important note for overseas coaches:Unfortunately, coaches living outside theUK cannot become Full FACA Membersas we are unable to ensure compliancewith the CRB checks required as part ofthe membership process.

However, coaches based outside the UKcan join as an Online FACA Member.

Membership benefits:

We all have a responsibility to promotehigh standards of behaviour in the game.In the FA’s survey of 37,000 grassrootsparticipants, behaviour was the biggestconcern in the game. This includedthe abuse of match officials and theunacceptable behaviour of overcompetitive parents, spectators andcoaches on the sideline.

Play your part and observe the FootballAssociation’s Respect Code of Conductin everything you do.

On and off the field, I will:• Show respect to others involved inthe game including match officials,opposition players, coaches,managers, officials and spectators

• Adhere to the laws and spirit ofthe game

• Promote Fair Play and high standardsof behaviour

• Always respect the matchofficial’s decision

• Never enter the field of play withoutthe referee’s permission

• Never engage in public criticismof the match officials

• Never engage in, or tolerate,offensive, insulting or abusivelanguage or behaviour

Coaches, Team Managers and Club Officials

When working with players, I will:• Place the well-being, safety andenjoyment of each player aboveeverything, including winning

• Explain exactly what I expect ofplayers and what they can expectfrom me

• Ensure all parents/carers of allplayers under the age of 18understandthese expectations

• Never engage in or tolerate anyform of bullying

• Develop mutual trust and respectwith every player to build theirself-esteem

• Encourage each player to acceptresponsibility for their own behaviourand performance

• Ensure all activities I organise areappropriate for the players’ abilitylevel, age and maturity

• Co-operate fully with others infootball (e.g. officials, doctors,physiotherapists, welfare officers)for each player’s best interests

I understand that if I do not followthe Code, any/all of the followingactions may be taken by my club,County FA or The FA:I may be:• Required to meet with the club,league or County Welfare Officer

• Required to meet with theclub committee

• Monitored by another club coach• Required to attend a FAeducation course

• Suspended by the club fromattending matches

• Suspended or fined by the County FA• Required to leave or be sacked bythe club

In addition:• My FACA (FA Coaches Association)membership may be withdrawn

FACA Membership – how to join

You can join today by either submittingthe attached application form, goingonline at www.TheFA.com/coach orphoning 0844 9808 212

To fully complete the Full FACAMembership application form youwill need:• Your FA CRB DisclosureCertificate Number

• Details of your level of qualificationsand the year in which they wereawarded

• Two passport-size photographs tobe used on your membership card

• A method of payment:- Cheque- Credit/debit card details or- Completed direct debit mandate

If you do not have all of the above(e.g. you are awaiting confirmation ofyour FA CRB Check), you can still startthe application process today and youwill be given immediate access to ‘FACALive’ and the weekly update emails.

Your membership pack will not be sentuntil we have all the required information.

Not yet applied for an FA CRB check?

If you are yet to complete an FA CRBform but want to apply for FACAmembership, you can request a CRBform as part of the application process.

Returning the application form andcompleting as much as you are able(including payment method) will enableyou to gain immediate access to ‘FACALive’ and the weekly update emails.

Once we have received all the detailsrequired (as described above) thenwe will send out your confirmationletter and membership pack so thatyou will be a FACA Member with fullentitlements to all the benefits.

Although payment is taken from youraccount immediately, your membershipyear does not start until you have beensent your membership pack andpayment will not be requested againuntil 12 months from this date.

Please Note:Online Membership does not offer thebenefit of FACA Insurance.

FACAPO Box 4695WarwickCV34 9FH

Telephone:0844 980 8212

Email:[email protected]

Visit:www.thefa.com/coach

CRB EnquiriesTelephone0845 210 8080

Email:[email protected]

SECTION B: COSTS - UK

SECTION A: PERSONAL DETAILS CONTACT DETAILS

THE FA COACHES ASSOCIATION MEMBERSHIP APPLICATION FORM (Please complete in BLOCK CAPITALS)

Surname*

Title (Mr, Mrs, Miss etc)*

First Name(s)*

Previous Name

Occupation

Date of Birth* DD / MM / YYYY

Post Code*

Address (to which all correspondence will be sent)*

I have the following Football Associationqualification(s) (or equivalent Qualification issuedby a bona-fide FIFA recognised Football Federation)

Qualification* � Year

Level 1

Level 2 (Coaching Certificate)

Level 3 (UEFA B)

Level 4 (UEFA A)

Level 5 (Pro-Licence)

Generic Tutor Training Course Completed

Tel No*

Mobile*

Email*

FULL FACA MEMBER (Tick box for payment method) Direct Debit £39.50 Cheque/Credit Card £44.50

ONLINE FACA MEMBER: £27.50. Visit http://facalive.thefa.com to register

SECTION C: PAYMENT

UK members are encouraged to pay by Direct Debit, thereby assisting FACA with cost savings whichare re-invested to provide the most effective service.

Please tick only one boxComplete the Direct Debit Instructions to obtain the Direct Debit discount. Tick box for this optionORPlease find enclosed cheque payable to 'The FA Coaches Association' for £44.50 Tick box for this optionORPlease charge my: (delete as appropriate)VISA / MASTERCARD / ACCESS / SWITCH /MAESTRO for £

Account No:

Expiry Date: Maestro / Switch Issue No:

Signature: Date

*Compulsory requirement

The FA Coaches Association DIRECT DEBIT APPLICATION FORM (Please complete in BLOCK CAPITALS)

INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY TO PAY BY DIRECT DEBIT

Pease fill in the form using a ballpoint pen and send it to:

The FA Coaches AssociationPO Box 4695WarwickCV34 9FH

Name and full postal address of yourBank or Building Society

To the Manager

Bank/Building Society

Address

Postcode

INSTRUCTION TO YOURBANK OR BUILDING SOCIETY

Please pay The FA CoachesAssociation Direct Debits from theaccount detailed on this instructionsubject to the safeguards assuredby the Direct Debit Guarantee.I understand that this instructionmay remain with The FA CoachesAssociation and, if so, details willbe passed electronically to myBank/Building Society.

4 03 3 1 6

ORIGINATORS IDENTIFICATION NUMBER

Bank / Building Society Account Number

�� Branch Sort Code

�� Banks and Building Societies may not accept Direct Debit instructions for some kinds of account

Name(s) of Account Holder(s)

The Direct Debit Guarantee

• This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change, FACA will notify you 10 working days in advance of your account being debited or as otherwise agreed.

• If an error is made by The FA Coaches Association or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Should you do this, then please also send a copy of your letter to us.

Signature(s)

THE FOOTBALL ASSOCIATION EQUALITY MONITORING FORM

Yes No

SECTION F: DATA PROTECTIONWe will process your information in accordance with The FA’s Privacy Policy which can be accessed by visiting www.TheFA.com

Please tick this box if you wish to receive future information from us, if you do not this will preclude you from receiving any of our special offers or promotions

Please tick this box if you wish to receive information from our group companies or from our carefully selected business partners

The Football Association would like to make available to Affiliated Associations (which include County FootballAssociations) and FA Football Development Officers the contact details of members of FACA who are willing to be approached to participate in their coaching initiatives. County Football Associations and Football DevelopmentOfficers would be able to use this information only for the purposes of recruiting coaches for their initiatives. Please tick this box if you wish us to disclose your details for this purpose

SECTION G: IMPORTANT INFORMATIONI hereby consent to The FA processing my application to join FACA, to my FA CRB Disclosure and any other relevant thirdparty enquiries (along with any further enquiries arising from the same). I hereby fully indemnify The Football Association inrelation to any claims, expenses, losses, damages or costs whatsoever that may arise as a result of The FA's processing of thisapplication and administration of The FA's coach licensing programme, including any decisions taken by The FA forsafeguarding reasons.I understand that the information contained on this form and other relevant information that I havesupplied, or arises from any other enquiry, will be recorded by The FA. I also understand that The FA abides by the CRB Codeof Practice and will not store for longer than necessary any information revealed on my Enhanced Disclosure. I understand thatI must inform The FA immediately of any change to any relevant information relating to my application to join FACA, forexample, but not limited to, a change of address or if I have been convicted of any relevant offence during the term of mymembership. I understand that action may be taken in relation to my membership and under the Rules of The FA in relation to the provision of incomplete or false information or where the information provided leads The Football Association to believethat action should be taken for any reason including but not limited to relating to the protection of children and/or vulnerableadults. Such action may include having my membership of FACA terminated.

SIGNATUREI CERTIFY THAT THE INFORMATION THAT I HAVE PROVIDED ABOVE IS CORRECT IN ITS ENTIRETY AND I CERTIFY THAT I HAVE READ, FULLY UNDERSTAND AND AGREE TO THE IMPORTANCE OF THE INFORMATION PROVIDED INTHIS SECTION G. I WISH TO APPLY FOR MEMBERSHIP OF THE FACA AND AGREE TO BE BOUND BY THE RULES OFTHE FOOTBALL ASSOCIATION, THE CONSTITUTION OF FACA AND THE GRASSROOTS FOOTBALL COACHES’ CODE OF CONDUCT (EACH AS SHALL BE AMENDED FROM TIME TO TIME).

SIGNATURE: DATE:

This form must be signed by a parent or carer if the applicant is under 18 years of age at the time of application

PRINT NAME (if parent or carer)

PLEASE COMPLETE AND RETURN THIS FORM TO: The FA Coaches Association, PO Box 4695, Warwick CV34 9FH

SECTION D: CRB DISCLOSURE Please read the following and tick the corresponding box:

I have a FA CRB Unit Enhanced Disclosure and the number is

Issue Date

I give my permission for FACA to contact The FA CRB Unit to ensure my Disclosure is current and accepted by The FA. I understand no other information about my Disclosure will be released to FACA.

We cannot process your FACA application form without your FA CRB Enhanced Disclosure number. If you have not completed your FA CRB check please either call us on 0844 980 8212 or email us [email protected] to request your form.

SECTION E: PHOTOGRAPHS All applicants are required to send two passport sized photographs. Please either:Attach two photographs to this form, with your name and date of birth clearly marked on the reverse of each photograph; OR Email your passport style photo to [email protected]. Title the email ‘Photo for FACA membership application’ and state your full name, date of birth and post code in the email.

Now, armed with this qualification, you are eligible for membership of The FA Coaches Association (FACA) – and we encourage you to join as soon as possible.

Why?Because your coaching career shouldn’t stop here, and FACA can play a huge role in developing your skills – to your benefit and those you coach.

How?• By giving you instant online access to an unrivalled archive of coaching tips, practices

and interviews with some of the game’s top practitioners• By allowing you access to the most comprehensive suite of free coaching development

days across our network of County FA’s working with qualified FA staff• By putting you in contact with the local and regional FA coaching support staff • By keeping you up to date with coaching vacancies, events and networking

opportunities both through our exclusive website FACA Live and through the FACA journal ‘Insight’, sent three times a year

There are lots more tangible benefits of FACA membership – all listed in this leaflet – and one key intangible one:

Irrespective of the level at which you coach, FACA membership shows you’re serious about coaching, and tells your players, their parents and your colleagues that you aim to continuously improve. You’ll be telling your players these messages week-in, week-out!

REFERENCE NUMBER (OFFICE USE ONLY)

We are keen to ensure that FACA membership is representative of the wider community. We ask for details of age,gender, ethnicity, religion, sexual orientation and disability status for equal opportunities monitoring purposes. This isrecommended by the codes of practice published by the Equality and Human Rights Commission to eliminatediscrimination and promote equality. In this regard this information will be used to monitor the impact of our action plans to increase diversity within FACA membership. This is extremely helpful and enables us to keep confidential andanonymous records of the people who coach in our national sport. By doing this we can spot any inequalities and workwith local communities to encourage more people to get involved incoaching. However, we totally respect your privacyand whilst it would be really helpful if you completed this section, it is not compulsory.

Under 18 18-30 31-40 41-50 51-60 61-65 Over 65

Gender

Please indicate if you are Male Female Do not wish to disclose

Ethnic background

Please choose one category from A to E and then please mark X in the appropriate box to indicateyour ethnic background

A. White B. Mixed C. Asian or Asian British

English White & black Caribbean Indian

Irish White & black African Pakistani

Scottish White & Asian Bangladeshi

Welsh Other Other

D. Black or Black British E. Chinese or Other Ethnic Group

Caribbean Chinese

African Other

Other Do not wish to disclose

Disability

Do you consider yourself to be a disabled person? Yes No

If you have ticked ‘Yes’, please mark X in all the boxes that apply to you:

Visual impairment Physical impairment Hearing impairment

Learning disability/difficulty Mental health issues Do not wish to disclose

Religion

Buddhist Jewish Muslim

Christian Muslim Sikh

Hindu Jewish No active faith

Other (please write in your preferred description) Do not wish to disclose

Sexual orientation

Heterosexual Bisexual

Gay Other (please write in your preferred description)

Lesbian Do not wish to disclose

Do not wish to disclose

4695 FACA-App-Foldout_Goth.qxd:2777 FACA_App_MemPack 17/12/09 09:43 Page 1

Surname*

First Name(s)*

Previous Name

Occupation

Post Code*

Level 1

Level 3 (UEFA B)

Level 4 (UEFA A)

Tel No*

Mobile*

Email*

SECTION C: PAYMENT

Account No:

Signature: Date

To the Manager

Address

Postcode

4 03 3 1 6

Signature(s)

Yes No

SIGNATURE: DATE:

Issue Date

Under 18 18-30 31-40 41-50 51-60 61-65 Over 65

Gender

Ethnic background

Welsh Other Other

Caribbean Chinese

African Other

Disability

Religion

Sexual orientation

Surname*

First Name(s)*

Previous Name

Occupation

Post Code*

Level 1

Level 3 (UEFA B)

Level 4 (UEFA A)

Tel No*

Mobile*

Email*

SECTION C: PAYMENT

Account No:

Signature: Date

To the Manager

Address

Postcode

4 03 3 1 6

Signature(s)

Yes No

SIGNATURE: DATE:

Issue Date

Under 18 18-30 31-40 41-50 51-60 61-65 Over 65

Gender

Ethnic background

Welsh Other Other

Caribbean Chinese

African Other

Disability

Religion

Sexual orientation

Surname*

First Name(s)*

Previous Name

Occupation

Post Code*

Level 1

Level 3 (UEFA B)

Level 4 (UEFA A)

Tel No*

Mobile*

Email*

SECTION C: PAYMENT

Account No:

Signature: Date

To the Manager

Address

Postcode

4 03 3 1 6

Signature(s)

Yes No

SIGNATURE: DATE:

Issue Date

Under 18 18-30 31-40 41-50 51-60 61-65 Over 65

Gender

Ethnic background

Welsh Other Other

Caribbean Chinese

African Other

Disability

Religion

Sexual orientation

Surname*

First Name(s)*

Previous Name

Occupation

Post Code*

Level 1

Level 3 (UEFA B)

Level 4 (UEFA A)

Tel No*

Mobile*

Email*

SECTION C: PAYMENT

Account No:

Signature: Date

To the Manager

Address

Postcode

4 03 3 1 6

Signature(s)

Yes No

SIGNATURE: DATE:

Issue Date

Under 18 18-30 31-40 41-50 51-60 61-65 Over 65

Gender

Ethnic background

Welsh Other Other

Caribbean Chinese

African Other

Disability

Religion

Sexual orientation

FACA APPLICATION FORM INSURANCE DETAILS (continued)

PERSONAL ACCIDENTINSURED PERSONAny member Coach Leader or Junior Team Manager of the Insured

BENEFITSa) Death occurring within two years of the event £50,000b) Loss of one or more limbs £50,000c) Permanent total loss of all sight in one or both eyes £50,000d) Other Permanent Total Disablement from any gainful employment for which

the insured person is fitted by education knowledge or training £50,000

OPERATIVE TIMEWhilst participating in any activity organised the Insured Person’s club including direct travel withinGreat Britain Northern Ireland the Channel Islands or the Isle of Man.

EXCLUSIONS 1) War and kindred risks2) Flying other than as a passenger3) Suicide4) Driving a motor vehicle with more than the permitted level of alcohol in the body5) Unlawful taking of drugs6) Undertaking a sport against medical advice7) HIV/AIDS and related illness8) Known Physical or mental infirmity

PLEASE NOTE: FACA insurance does not cover coaches coaching children under 5 years old. All cover issubject to the Terms, Conditions and Exceptions of the Master Policy held by Perkins Slade Limited andavailable for inspection upon request.

It is important that you complete the following:

Have you ever been refused cover Yes No

Had special terms imposed upon you Yes No

Yes No

If “yes” to any of the above, please provide details.

I/We declare to the best of my/our knowledge and belief that the above statements are true and complete and will form part of the contract between me/us and the Insurer

SIGNATURE:

If you are in any doubt about whether facts are material, you must tell us. Failure to do so could affect the validity of your policy.

THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR APPLICATION FORM. YOUR APPLICATION CANNOT BE PROGRESSED UNTIL A COMPLETED FORM IS RECEIVED BY FACA.

All personal information supplied by you will be treated in confidence by the Royal & Sun Alliance Insurance Group of companies and will not be disclosed to anythird parties except where your consent has been received or where permitted by law. In order to provide you with products and services this information will beheld in data systems of the Royal & Sun Alliance Insurance Group of companies or our agents or subcontractors. The Royal & Sun Alliance Insurance Group ofcompanies may pass your personal data to other companies for processing on its behalf. Some of these companies may be based outside Europe in countries,which may not have laws to protect your personal data, but in all cases the Group will ensure that it is kept securely and only used for the purposes for which youprovided it. Details of the companies and countries involved can be provided to you on request. The parties to the Policy have the right to choose the law applicableto the Policy. Unless the parties agree otherwise in writing any dispute concerning the interpretation of this Proposal or the Policy shall be governed and construedin accordance with English law and shall be resolved within the non-exclusive jurisdiction of the courts of England and Wales.

FACA APPLICATION FORM INSURANCE DETAILS

PERSONAL DETAILS CONTACT DETAILS (Telephone numbers)

Surname

Title (Mr, Mrs, Miss etc)

First Name(s)

Previous Name

Address (to which all correspondence will be sent)

Postcode

Mobile

As a result of new duties under the Financial Services Authority regulations we are required to asksome additional information from you prior to the insurers providing you with cover. The insurerreserves the right to decline to provide cover.

CLAIMS INFORMATIONHave any accidents or claims (whether insured or not) arisen in connection with your footballing activities in past 5 years.

Yes No

Date of accident Brief details Amount of claim

If yes, please give details below of all claims made against you and whether insured or not.

CIVIL LIABILITY INSURANCEThe policy is on a “claims made” wording. This means that a claim will be notified under the policywhich is in force at the time you first become aware that a claim may be made against you and not atthe time the alleged error occurred. The cover is civil liability to pay damages and costs in respect ofclaims for injury or damage, arising out of the FACA coaching activities made against the insuredduring the Period of Insurance.

The Limit of Indemnity is £5,000,000 including costs

The term civil liability includes:Public Liability, Products Liability, Member-to-Member Liability, Libel & Slander, Errors and Omissions

Cover includes:Coaching, Teaching, Instruction undertaken by members of the FACA both Paid and Unpaid.Worldwide coverIndemnity to Principals i.e. rented facilities.

Principle Exclusions:Goods and or items held in trust by the insured or in their custody or controlLiability accepted under agreementOwnership or use of – mechanically propelled vehicles, aircraft or other aerial devices waterborne craftAdvice or design in respect of manufacture or construction

/FALearning

You’ve got the skills – now join the club

• Access to more than 200 free coaching events across the country• Online access to world-leading coaching advice• Comprehensive insurance cover• Exclusive ‘Member-only’ events• And much, much more

From £39.50 a year

Please complete pages 1-6 of this form including,if relevant, the Direct Debit instruction on page 2.

Detach the whole form from the booklet, moisten the gummed strips and seal, ensuring the return address is on the outside and send to:

FACA ApplicationsThe FA Coaches AssociationPO Box 4695Warwick CV34 9FH

Where did you hear about us?

What is the main reason for joining FACA?

This publication can be made available in large print, audio or Braille. For more information please contact The FA's Customer Relations Unit on 0844 980 8200.

CATION F

09 Befo

ion, c

.Been convicted or have a prosecution pending for any offence involvingdishonesty of any kind (Unless fully rehabilitated under the terms of theRehabilitation of Offenders act 1974)

Application Pack

To be a FACA member you must hold an FA CRB Enhanced Disclosure. To receive your CRB form call 0845 210 8080

Yes No

SIGNATURE:

Surname

First Name(s)

Previous Name

Postcode

Mobile

Yes No

/FALearning

From £39.50 a year

CATION F

09 Befo

ion, c

Application Pack

Yes No

SIGNATURE:

Surname

First Name(s)

Previous Name

Postcode

Mobile

Yes No

/FALearning

From £39.50 a year

CATION F

09 Befo

ion, c

Application Pack

Yes No

SIGNATURE:

Surname

First Name(s)

Previous Name

Postcode

Mobile

Yes No

/FALearning

From £39.50 a year

CATION F

09 Befo

ion, c

Application Pack

Complete the online module at TheFA.com/RespectGuide

WHATEVER YOU WANT TO BE IN FOOTBALL

THERE’S AN FA LEARNING COURSE FOR YOUCoaches: Introductory, advanced and specialist qualifications Referees: Basic and advanced courses Medics: Medical and exercise science courses Administrators: Online courses Tutors: Training and development Welfare Officers: Safeguarding Children and Welfare Officer workshops County FA staff, Charter Standard League and Club Officials: Race, Disability and Equality workshops. Plus an ongoing series of events and conferences.

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FA Coaching Association App Form

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Transcript of FA Coaching Association App Form