• All names must be entered exactly as they appear in your passport for immigration purposes.

First Name * Middle Name *(if you have one)

Last Name * Position applied for * Please Select Summer 2013 Summer / Fall 2013 Seasonal (Spring/Summer/Fall) 2014 Summer 2014 Summer / Fall 2014 Athletic Trainer 2013 Internship 2013
2013 positions are for US residents only

Sex * Male Female I am also interested in full time positions with U.K. Elite

Birth Date * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December Birth Year * Marital Status Please Select Married Single

Driver * No Yes Learning Citizenship Please Select Other United Kingdom United States Citizenship if other

Driving Record

Home Address * Line 2

City * County/State *

Post Code/Zip * Country * Please Select England Ireland Northern Ireland Other Scotland United States Wales Country if other

Home Phone or Email *

Cell Phone * Confirm Email *

Term Address Line 2

City County/State

Post Code/Zip Country Please Select England Ireland Northern Ireland Other Scotland United States Wales Country if other

Term Phone Email

College/University Dates attended

Course Qualifications

College/University Dates attended

Course Qualifications

Qualification Year obtained (yyyy)

Qualification Year obtained

Qualification Year obtained

1st Sport Qualification Years experience

2nd Sport Qualification Years experience

Current Position * Since

Employer

Duties
250 max

1st Position Start/End Dates

Organization

Duties
250 max

2nd Position Start/End Dates

Organization

Duties
250 max

1st Skill Please Select Communications Information Technology Other (Please explain) Public Relations Sales & Marketing Years Experience

Please explain
250 max

2nd Skill Please Select Communications Information Technology Other (Please explain) Public Relations Sales & Marketing Years Experience

Please explain
250 max

Briefly explain your reason for applying for a position with U.K. Elite Soccer.

Please explain *
500 max

What unique skills do you think you can bring to U.K. Elite Soccer?

Please explain *
500 max

Passport No. Country of Issue Please Select Other United Kingdom United States Country if other

Issue Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December Issue Year Expiration Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December Expiration Year

Have you ever been refused entry to the USA? * Yes No (If yes, please describe below)

Have you ever been refused a Visa for the USA? * Yes No (If yes, please describe below)

Do you have any current criminal convictions? * Yes No (If yes, please describe below)

Have you ever been accused of, or involved in an incident
involving the sexual or physical abuse of a child? * Yes No (If yes, please describe below)

Please describe
250 max

Do you smoke? * Yes No

Have you ever had any serious or permanent debilitating
illness / limitations? * Yes No (If yes, please describe below)

Are you currently undergoing any medical treatment? * Yes No (If yes, please describe below)

Do you currently take any prescription medication? * Yes No (If yes, please describe below)

Do you have any allergies? * Yes No (If yes, please describe below)

Please describe
250 max

Name * Association

Phone or Email *

Job Source * Please Select UK Elite Employee College or University Internet Browsing Job Center FC Business Magazine Leisure Jobs Website 442 Magazine Leisure Opportunities Other (Please specify) Leisure Media She Kicks Magazine Employment 4 Students World Soccer Magazine FootballJobs.com US College Coach The Football Association Chelsea Football Club Referred By

Declaration * I confirm that the information given on this form is to the best of my knowledge true and correct, any false statement may be sufficent cause for resignation or dismissal.