VOLUNTEERS 2012/2013 CLUB NAME: To access Zone Press Online England Basketballs monthly magazine and to receive news, updates and offers please include your Email address below. PLEASE COMPLETE YOUR FULL NAME , EMAIL ADDRESS AND POSTAL ADDRESS IN UPPER CASE NC Please circle the activities you perform as a volunteer at your club DATE OF BIRTH dd/mm/year Ethnic Origin Key : White; British White (W), Irish White (WI), Other White (WO). Mixed; White & Black Caribbean (MBC), White & Black Please circle as African (MBA), White & Asian (MA), Other Mixed (MO). Asian; Indian (I), appropriate Pakistani (P), Bangledeshi (B), Chinese (C) Other Asian (AO). Black; Black Caribbean (BC) , Black African (BA), Other Black (OB). GENDER Do you have any long-term illness or health problemand/or disability which limits your daily activities? ETHNIC ORIGIN FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE FULL NAME HOUSE NO EMAIL POSTCODE Administrator Coach Court Announcer Referee Male Statistician Table Official Team Manager Other Administrator Coach Court Announcer Referee Statistician Table Official Team Manager Other Coach Court Announcer Referee Administrator Table Official Coach Team Manager Court Announcer Administrator Table Official Coach Team Manager Court Announcer Administrator Table Official Coach Team Manager Court Announcer Team Manager Other Court Announcer Referee Disability ? Statistician Table Official Team Manager Other Administrator Coach Court Announcer Referee Disability ? Administrator Coach Court Announcer Administrator Table Official Coach Team Manager Court Announcer Statistician Administrator Table Official Coach Team Manager Court Announcer Team Manager Other Referee Statistician Table Official Team Manager Other Administrator Coach Court Announcer Referee Administrator Coach Court Announcer Table Official Team Manager Long Term Illness ? Disability ? Long Term Illness ? W W P WI Long Term Illness ? W OB C MBA O MA AO BC WO BA MBC MO OB C MBA O MA AO BC WO BA MBC MO OB C MBA O MA AO BC WO BA MBC MO OB C MBA O MA AO BC WO BA MBC MO OB C MBA O MA AO BC WO BA MBC MO OB C MBA O MA AO BC WO BA MBC MO OB C MBA O MA P WI AO BC WO BA MBC MO OB C MBA O MA Female Disability ? Long Term Illness ? W P WI AO BC WO BA MBC MO OB C MBA O MA Female I Disability ? Long Term Illness ? Disability ? Long Term Illness ? Disability ? Long Term Illness ? W P WI AO BC WO BA MBC MO OB C MBA O MA Female I W P WI AO BC WO BA MBC MO OB C MBA O MA Female I W P WI AO BC WO BA MBC MO OB C MBA O MA Female Other I Referee Other P WI I Disability ? Male Statistician Disability ? Disability ? Male Team Manager Long Term Illness ? P WI I Male BA MBC MO Female Referee Court Announcer Table Official Disability ? Other Coach BC WO Female Referee Table Official P WI W Other Statistician AO Female Referee Administrator MA Female Other Male Statistician Long Term Illness ? W I Male P WI I Male Statistician Long Term Illness ? W I Male P WI I Male MBA Female Referee Coach P WI W Other Table Official MBC MO Female Referee Statistician Team Manager W Other Administrator Table Official Long Term Illness ? WO Female Referee Male Statistician Disability ? WI I Male Statistician Long Term Illness ? Other Male Statistician Disability ? W I Male Statistician Long Term Illness ? I Male Administrator Disability ? Female Long Term Illness ? W P WI AO BC WO BA MBC MO OB C MBA O MA Female I P AO BC BA OB C O Communication: Any information provided by you will be held by England Basketball on its computer records. We will from time to time send you electronic communication via email. If you do not want to receive these communications please tick the NC column by your name. PLEASE NOTE: This will mean you will NOT receive Zone Press Online or any other EB communication.
© Copyright 2024 ExpyDoc
