Shared Access

Welcome to this enquiry form regarding the potential to provide a turnkey floodlighting solution at your club which will meet agreed standards, should your location prove suitable for their clients. Please fill in the order and we will be in touch over the coming month(s).

Personal Details

Title^*

First Name^*

Last Name^*

Club Name (In Full)^*

House Number^*

Address 1^*

Address 2

Address 3

Town or City^*

County^*

Post Code^*

Address Type^*

Home Club Work

Contact Number^*

Number Type^*

Mobile Home Club Work

Fax Number

Email^*

Role/Position in Club^*

Club Details

Please submit exact address of Club grounds

Club Address 1^*

Club Address 2

Club Address 3

Club Town or City^*

Club County^*

Club Post Code^*

Site / Aerial Photographs Available^*

Yes No

What is the Status of ownership of the Ground^*

Who is the Superior Landlord^*

Years left on the lease

What is the land registry number of the clubs held

Do you have title to issue a lease^*

Yes No

Are there any existing wireless / mobile phone companies located at your ground?^*

Yes No

Are architectural drawings of your club grounds available?^*

Yes No

Have you been approached by any wireless / mobile phone companies?^*

Yes No

If yes, which company?

What type of ground best describes where your club is located?^*

High Low lying

Are there any tall buildings / trees (i.e. over 2 storeys) nearby?^*

Yes No

Is there a clubhouse on site?^*

Single Storey Two Storey Non Applicable

Do you have plans to install floodlights?

Yes No

Do you have planning permission for future floodlighting?

Do you currently have floodlighting?^*

Yes No

If yes, How many Columns?^*

If yes, what is the approx height of columns (in meters)?^*

Pitches

Of the following types, how many pitches do you have?
If you don't have any please enter the number 0
	Artificial	Natural
Full Size	Artificial Full Size pitches	Artificial Full Size pitches
9-a-side	Artificial 9-a-side pitches	Artificial 9-a-side pitches
7-a-side	Artificial 7-a-side pitches	Artificial 7-a-side pitches
5-a-side	Artificial 5-a-side pitches	Artificial 5-a-side pitches

Does your club have 3 Phase power?^*

Yes No Not Sure

Data Disclosure Section

The data you provide will be stored in compliance with the Data Protection Acts and in accordance with the Irish FA Data Protection Policy. Your data will not be shared with any other body or organisation (including sponsors) unless you have stated explicitly that you wish us to do so. Your data may also be used for statistical purposes. ^*

Consent to Share Data with Shared Access
Do not consent to Share Data with Shared Access

If you consent, your personal details will not be used by Shared Access Limited for future marketing campaigns or promotions and will not be forwarded to third parties by Shared Access Limited. If you do not tick the box your details can not be forwarded to Shared Access Limited and you will not be able to benefit from the floodlighting scheme.

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