Hardship Scheme Application Form

Please Note: It is essential that you complete this form at least 2 working days before the trial date you would like to attend. Applications after this time may not be processed. Your application will be responded to by email within 1 working day. ALL APPLICATIONS ARE TREATED IN THE STRICTEST CONFIDENCE AND NEITHER PRO11 COACHING STAFF OR THE SCOUTS IN ATTENDANCE AT THE TRIAL WILL BE MADE AWARE OF YOUR APPLICATION.

Please say which trial date or location would you like to attend *

Name of the player applying for a place *

Name of the person completing this form *

Your relationship to the player, eg parent, family member, guardian, carer, social worker, teacher, coach etc. *

What is the player's date of birth *

What is their current age? *

Playing Age Group at time of trial (if known)

Player's full address including postcode? Please note all players must be resident in the UK, have a relevant VISA or have been granted refugee status *

Contact Telephone Number (Parent if under 16) *

Contact Email Address (Parent if under 16) *

Confirm Email

1st Preferred Playing Position *

2nd Preferred Playing Position

Current Club(s) - please provide name of any clubs the player currently plays for, and any football academy experience they have *

Please say why the player wishes to apply for the Hardship Scheme (please tick as many boxes as are relevant) *

Any further information you would like us to consider in support of this application

Medical Information *

Please advise of any current ongoing medical conditions that we should be aware of. Please also feel free to speak to a member of staff about any concerns. If none please write 'None' or N/A

If we are unable to offer you a free place, would you like us to provide you with a place at a discounted rate? *

Yes please
No thanks

Choice 1

I confirm that I have read and understood the Terms and Conditions of Booking and also the precautions taken against COVID_19 www.pro11trials.co.uk/terms-and-conditions & www.pro11trials.co.uk/corona-virus

This form has been electronically signed by (please type your name) *

Date *

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