Women's Club Return Form 2021

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Club Membership, Under IFA Article 4 for Season 2021 (please complete no later than 1 March 2021)

Team name *

League in which club will compete *

Affiliated by Divisional Association *

Legal Entity *

If other, please specify:

Club Secretary Details

First name *

Last name *

Mobile number *

Email Address *

Club Information

Club Kit Colours - First Choice * Shirt/Shorts/Socks

Club Kit Colours - Second Choice * Shirt/Shorts/Socks

Club’s Registered Ground (including address and postcode) *

Floodlights (Yes/No) *

Club bank account name *

Playing Surface *

Match night *

Club Personnel Information

Club Chairperson's Name *

Contact Number *

Email Address *

Club Disciplinary Officer's Name *

Contact Number *

Email Address *

Club Child Welfare Officer's Name *

Contact Number *

Email Address *

Additional Contact Person: Name *

Additional Contact Person: Contact number *

The information submitted will be used for legitimate football administration purposes.

The Irish FA will retain the information provided for the duration for the 2021 season.

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