CUP COMPETITIONS ENTRY FORM
Season 2019-2020
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HEAVY WOOLLEN DISTRICT FOOTBALL ASSOCIATION
Founded in 1898
President - R G Secker Esq
Affiliated to the West Riding County F.A.
MEMBERSHIP RULE ONE
West Riding County Football Association Membership Rule 1 states that all affiliated Clubs playing in the area covered by the Heavy Woollen District Football Association are expected to enter the appropriate Competition.

Any club that has more than one team may enter additional teams in the Competition on payment of the correct entrance fee for each team. Players can however only play for one team in any one season in the competition. Please enter the name and full details of each individual team on a separate form.
ENTRY DETAILS
Team Name *
Team Managers Name *
Team Managers Email address *
Club Secretary Name *
Club Secretary postal address (including postcode) *
Club Secretary mobile number *
Club Secretary email address *
Club contact name, phone number & email (if not as above)
1st choice team colours *
2nd choice team colours *
League / Division playing in *
Ground location *
Location of changing rooms *
COMPETITION ENTRY REQUIRED
*
Required
ENTRY FEE (PER TEAM)
To be paid on or before August 22nd 2019. BACS transfer is the preferred method.
Please select
BACS
Cheque
Other
Wheatley Cup £15
Brook Butler Cup £15
Blackburn Cup £10
Secker Cup £10
HEAVY WOOLLEN DISTRICT F.A. BENEVOLENT FUND
The Heavy Woollen FA welcomes donations from Clubs to enable them to continue to give financial assistance to players, referees, and all grassroots workers in local football in need of financial assistance.

Clubs are asked to give the benevolent fund their full suppport by making a financial donation to the fund.

All requests are considered; please contact the HWDFA secretary when in need of advice.
Benevolent Fund contribution *
TOTAL PAID
Entrance fee (plus any donation to Heavy Woollen FA Benevolent Fund)
£ *
PAYMENT DETAILS
Entry fee & donations can be paid by cash, cheque or direct bank transfer.

Sort Code: 05-04-09
Account Number: 17950048

Direct bank transfers must clearly state your team name and competition.

Cheques to be made payable to: ‘Heavy Woollen District Football Association’ and posted to Mr D Chown, 17 Cockshott Drive, Leeds, LS12 2RL (no personal callers or hand deliveries).
Digital Signature *
Please enter your full name below on behalf of your Club. By doing this, your Club agrees to be bound by the Rules of the District Cup Competition entered and by Memorandum of Rules of the Heavy Woollen District Football Association. This includes the management of your personal data in accordance with the Privacy Policy of the Heavy Woollen District FA (provided separately).
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FORM SUBMISSION
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