EHACAD Form 4 E n g l a n d H a n d b a l l A s s o c i a t i o n C o u r s e A d m i n i s t r a t i o n i n c o n j u n c t i o n w i t h S p o r t S t r u c t u r e s Delegate Registration Form

This form must be completed (in CAPITALS) by individual delegates on the course and handed to the course tutor:

EHA L1 Certificate in Coaching Saturday 21st February 2015 Handball Garth Hill College 09:00 – 15:00 Forename Nationality Surname Date of Birth Address Gender Mob. number Town Tel. home Postcode Email address

I ______wish to be registered on the England Handball Association database. I agree to abide by the rules and regulations of the British & England Handball Association. Please tick’ box if you wish to opt out of receiving regular EHA updates Signature Print Name Date

Equal Opportunities Monitoring and Evaluation In order to comply with Equal Opportunities regulations please complete the following monitoring and evaluation:

White  Mixed and Ethnic  Black or black British  Background British White & Black Caribbean Caribbean Irish White & Black African African Any Other background White & Asian Any other background Any other mixed background Asian or Asian British  Other Ethnic Background  Indian Chinese Pakistani Any other background Bangladeshi Any other background Payment Please use this section to communicate what method of payment you will be using to pay. Payment amount due is £55 Payment Types Payment Details Payment amount Please make cheque payable to “Berkshire County Sports Partnership” and send cheques and Delegate Form to Get Berkshire Cheque Active Office, Temple Room, 1st Floor, The Abbey, Bisham Abbey NSC, Marlow Road, Nr. Marlow, SL7 1RR Please transfer payment to the following bank details: Account name: Get Berkshire Active, Account Sort Code 20-40-71 and Bank Transfer Account number: 13540960 with the reference EHAL1_0215“YOUR SURNAME” Please drop of in person with your delegate form to the Get Berkshire Cash Active Office, Temple Room, 1st Floor, The Abbey, Bisham Abbey NSC, Marlow Road, Nr. Marlow, SL7 1RR

Please return to: England Handball Course Administration, Sport Structures, Coach Education, Concorde House, Trinity Park, Solihull,, Birmingham, B37 7UQ