Staffordshire County Senior League

Referee Registration Form

All fields (where applicable) must be completed in full before submission.

Referee Registration Form

Full name

Contact email address

Contact telephone number

Alternative contact telephone number


I confirm that I will be 18 years of age or more on the 1st August 2020

Due to being 18 years of age or under please provide the following information:

Date of birth of the young referee

parent/guardian contact telephone number

parent/guardian contact email

Do you have a SCSL Badge?

Current referee level

How many years have you been at that level?

Have you applied for promotion?

Applied for level

Do you have your own transport?

Which League's did you officiate on last season? (If none, state 'none'.)

Please indicate any known closed dates for August/September/October 2020

Data Protection, Privacy Notice & Social Media Policy Statement:

I give STAFFORDSHIRE COUNTY SENIOR LEAGUE permission in accordance with the Leagues Data Protection, Privacy Notice & Social Media Policies.

I give authority for STAFFORDSHIRE COUNTY SENIOR LEAGUE’s Committee to store and administer the above provided information, as required to fulfil its operational duties in administering and manage the League’s Competitions.