CLUB & LEAGUE
DETAILS FORM
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FOR OFFICIAL USE ONLY - Please provide details requested below

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Club Name

League Name

CHAIRMAN

Chairman's First Name

Chairman's Last Name

Chairman's Address

Chairman's First Line of Address

Chairman's Postcode

Chairman's Country

Chairman's Email

Chairman's Phone Number

SECRETARY

Secretary's First Name

Secretary's Last Name

Secretary's Address

Secretary's First Line of Address

Secretary's Postcode

Secretary's Country

Secretary's Email

Secretary's Phone Number

TREASURER

Treasurer's First Name

Treasurer's Last Name

Treasurer's Address

Treasurer's First Line of Address

Treasurer's Postcode

Treasurer's Country

Treasurer's Email

Treasurer's Phone Number

CHIEF MARSHAL

Chief Marshal's First Name

Chief Marshal's Last Name

Chief Marshal's address

Chief Marshal's First Line of Address

Chief Marshal's Postcode

Chief Marshal's Country

Chief Marshal's Email

Chief Marshal's Phone Number

SAFETY OFFICER

Safety Officer's First Name

Safety Officer's Last Name

Safety Officer's address

Safety Officer's First Line of Address

Safety Officer's Postcode

Safety Officer's Country

Safety Officer's Email

Safety Officer's Phone Number

CHIEF SCRUTINEER

Chief Scrutineer's First Name

Chief Scrutineer's Last Name

Chief Scrutineer's address

Chief Scrutineer's First Line of Address

Chief Scrutineer's Postcode

Chief Scrutineer's Country

Chief Scrutineer's Email

Chief Scrutineer's Phone Number

SAFEGUARDING OFFICER

Safe Guarding Officer's First Name

Safe Guarding Officer's Last Name

Safe Guarding Officer's Address

Safe Guarding Officer's First Line of Address

Safe Guarding Officer's Postcode

Safe Guarding Officer's Country

Safe Guarding Officer's Email

Safe Guarding Officer's Phone Number

MEMBERSHIP SECRETARY

Membership Secretary's First Name

Membership Secretary's Last Name

Membership Secretary's address

Membership Secretary's First Line of Address

Membership Secretary's Postcode

Membership Secretary's Country

Membership Secretary's Email

Membership Secretary's Phone Number

NAME OF PERSON SUBMITTING FORM

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CLUB & LEAGUE DETAILS FORM NEW