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ENGLAND BASKETBALL

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ENGLAND BASKETBALL
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Club Accreditation Scheme



As part of England Basketball’s club development programme could you please complete

the application form (club details and club audit form) below and enclose copies of any

supporting evidence. Please use the Club Accreditation Scheme Criteria (available on

our website) to assist you in this application. The completion of this form will enable

England Basketball to ascertain the accreditation level of your club.



Name of club: ______________________________



Name of secretary: __________________________



Address:

________________________________________________________________________

____________________________________________________________________



County: ____________________________________



Postcode: __________________________________



Communication

(Home) ____________________________________

(Work) ____________________________________

(Fax) ____________________________________

(E-mail) ____________________________________



Club affiliation number: ______________________

Area/league affiliation : ______________________



In your application you should detail the following:-

 Your club membership on another sheet. Your list should identify age and gender.

 Your club’s coaches and officials and the qualifications they hold.

 Your clubs competitive structure i.e. the leagues and competition your club plays in

and/or organises.

 Any partnerships your club has to develop the sport. For example, Schools, Local

Authority, Area or Regional Associations.

 Your development plan and constitution.





Please send your completed application by email to craig.costello@englandbasketball.co.uk

or post to:



Craig Costello

England Basketball

PO Box 3971

Sheffield

S9 9AZ

Declaration of active coaches and officials (please use another sheet if

required)

Name of Coach Qualification(s)









Club Coaching Coordinator Email address









Name of Referee Qualification(s)









Name of Table Official Qualification(s)

Club Accreditation Application Form

Club name:

Do you have a Club Constitution YES / NO

Club Registration Number: (if Yes then please enclose a copy)



Male Female Total Do you have a Development Plan YES / NO

Number of registered Players (If Yes then please enclose a copy)

Number of registered Coaches

Number of registered Referees Do you have a link with your Local YES / NO

Number of registered Table Officials Authority or County Sports Partnership

(If Yes then please provide evidence

Number of unregistered Players

Do you have any links with local schools YES / NO

Number of club members qualified (If Yes then please provide evidence)

as Coaches

Does your club have a Club Coaching YES / NO

Number of club members qualified

as Referees

Co-ordinator?

Number of club members qualified (if Yes then please provide their name

as Table Officials and Email address)





Signature: _______________________

Competition

Date: _______________________

Please list all the teams in the Club.



Team Senior / Junior Level of OFFICIAL USE ONLY (England Basketball)

Male / Female competition









STAR RATING ___________


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