BTBA Licence Application

To request your Coaches or Officials Licence please complete and submit this form.

Please complete all required fields on this form - which includes attaching a recent photograph of yourself. Without this information and your picture we are not able to process your application.

We regret applications cannot be requested by post, email or by telephone.

BTBA Number

Name

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Post Code

Telephone*

Area CodePhone Number

Mobile

Area CodePhone Number

E-mail*

Confirmation Email

Date of Birth*

DayMonthYear

New application or Renewal*

Type of Licence Requested

CoachingOfficial - Youth LeagueNon Playing Official - Youth LeagueNon Playing Official - Adult League

DBS Certificate Number*

this is found at the top of your DBS Certificate and usually starts with 001

Please select one qualification from the list below.

Current Coaching Qualification*

Official's Role*

YBC / Group / Centre supported

Photograph Upload*

Declarations and Signature

Please read the following carefully, before signing the application form at the end.

"I wish to apply for a BTBA Coaches or Officials Licence and understand that it will be issued subject to the following:

i) My BTBA membership is current or I have/require affiliate membership.

ii) My DBS Certificate is deemed satisfactory by the BTBA and is registered on the DBS Update Service.
iii) My qualification is current and recognised by the BTBA. - As of January 2018 Phase certifications (pre-2015) and Transition Qualifications are no longer accepted.

iv) Personal information gathered on this form will be stored and used to ensure the sucessful completion of this application. After which time relevant data will be held on the BTBA Membership database in accordance with the data retention policies which are available on our website.

Please note: all Licenced Coaches are covered by the BTBA Personal Indemnity and Public Liability Insurance whilst they are volunteering for the BTBA.

I understand that my licence will only remain valid whilst the conditions allowing the issue of it remain valid."

Signature*

Please sign this form electronically by typing your full name into this box.

Submition Date*

DayMonthYearHourMinutes

Enter the message as it's shown*

Coaches & Officials Licence Application / Renewal

Declarations and Signature