Gwent County Football Association and Acknowledge the Club Will Abide by the Rules of the Association

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Gwent County Football Association and Acknowledge the Club Will Abide by the Rules of the Association

Gwent County ‘FORM ‘A’ Application for Affiliation Season 2019/2020 Football Association Name of Club: Year of Formation: Address of Ground: Club Colours Name & Address of Senior Club Secretary Name & Address of Junior Club Secretary Post Code: Post Code: Tel: Tel: Senior Club Email: Junior Club Email: Safeguarding Officer: DBS # LEAGUE/S IN WHICH CLUB INTENDS TO PLAY – PLACE AN X IN RELEVANT BOX/S ONE AFFILIATION FEE COVERS ALL TEAMS WITHIN A CLUB. English Pyramid System £50.00 North Gwent Sunday League £20.00 Welsh Premier League £50.00 Islwyn Junior League £10.00 Welsh Women’s Premier League £50.00 Monmouthshire Junior League £10.00 Welsh League £40.00 Newport District Junior Youth League £10.00 Gwent County League £25.00 Torfaen Junior League £10.00 Gwent County Youth League £10.00 South Wales Women’s & Girls League ** East Gwent League £20.00 Boys & Girls Clubs of Wales ** Gwent Central League £20.00 Welsh Veterans League ** Newport & District League £20.00 Pan Disability League ** North Gwent League £20.00 Other (Please state in the next line) ** Applications to play in these Competitions must be made in writing (a fee may apply) ASSOCIATION CUP COMPETITION ENTRY – PLACE AN X IN RELEVANT BOX ONLY APPLICABLE TO CLUBS WHO DO NOT ENTER THE FAW WELSH CUP CLOSING DATE 1st JULY (there is a separate form for Junior under 14 & 16 Cups) Senior Cup (Level 5 Clubs Only) £20.00 Amateur Cup (Level 6 & Below) £20.00 On behalf of the Club named above I apply for affiliation to the Gwent County Football Association and acknowledge the Club will abide by the rules of the Association. I enclose the fee, covering League & Cup, of £ …………………... Cheque to be made payable to The Gwent County Football Association Ltd. Please note: if a cheque is not attached the affiliation will not be accepted. Signed: ……………………………………………………………………………………. Date: …………………………. Club Secretary The GCFA is committed to safeguarding the privacy of your personal information. All personal information supplied on this form will be held in accordance with the GDPR 2018. The purposes for which your personal information will be held are detailed in the GCFA Privacy Policy which can be obtained for the Association Secretary or via www.gwentfa.co.uk. By signing this form, you consent to your personal information being held in accordance with the Privacy Policy. This Form is to be sent together with the fee & a duly audited Balance Sheet to: Mr A. Watkins, Association Secretary, 1 Ashtree Cottages, Aberbeeg, Abertillery, Blaenau Gwent. NP13 2AT. .

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