Student Application Form
 
We are currently in the process of arranging Leadership and Volunteering Courses for students.   The first course we will run is the Junior Football Organiser Course.   This will be held at Norton Canes High School on 12 April 10.00-16.30.

To find out more about the course before you apply please visit Staffordshire FA

If you would like to apply to go on the course please complete this application form by 19 March:

Following on from you completing this application form you will recieve an email with further details and a parental consent forms, which must be completed, and along with your cheque, made payable to 'Staffordshire County Council' sent to:

Richard Rollason, Hagley Park Sports College, Burnthill Lane, Rugeley, WS15 2HZ

* = must provide information

Name *:

Email *:

Gender *:

Female
Male

Age *:

Year Group *:

Year 7Year 8Year 9Year 10Year 11Year 12Year 13

School *:

Hagley ParkFair OakCannock ChaseBlake ValleyKingsmeadCardinal GriffinNorton CanesOther

Are you signed up to the Step into Sport Passport? *:

Yes
No

If yes, approximately how many hours have you done? :

Please can I register for the following Course :

Junior Football Organiser at Norton Canes High School 12 April 2010Golf LeadersTennis LeadersPool Side HelperBadminton Leaders

How do you plan to use this qualification? *:

Thank you and you will be contacted shortly.   If you have any questions please feel free to contact us.

• Hagley Cluster
• Fair Oak Cluster
• Cannock Chase Cluster
• Cardinal Griffin Cluster
• Norton Canes Cluster
• Blake Valley Cluster
• Kingsmead Cluster
• Step into Sport
• Young Ambassadors
• Competitions
• PESSYP Case Studies
• Top Up Swimming
• Playground 2 Podium