ECB Association of Cricket Officials Application for Membership

ECB ACO Membership, ECB Offices, Warwickshire County Cricket Ground, Edgbaston, Birmingham B5 7QX

The ECB may wish to contact you regarding future opportunities, including those of ECB commercial partners (a full list is

available on www.ecb.co.uk) in which you may be interested.

Consent: by submitting this form, you understand that you are consenting to receive information from the ECB

about opportunities by post, phone, email or SMS. If you do NOT wish to receive such information please tick this box:

You are entitled to a copy of the information held about you for which a fee may be charged. Details of how to do this will be

provided by your County Board on request.

Signature: Date:

Membership No: Official use only

By submitting this form you are agreeing that the England and Wales Cricket Board (ECB) may use the information

provided on this form together with other information held about you including your education and history

as a cricket official and/or as a member of the cricketing community (together Information) to:

Administer membership of the ECB ACO including keeping your affiliated County ACO

informed of your membership status

Administer your attendance and completion of courses

Administer your benefits to ensure you get the most from your membership.

The ECB will hold your Information in a database which may be searched by County

ACO’s/Boards each of which may use it to:

Verify your qualifications and qualification criteria

Provide pre and post course administration.

*You will automatically be affiliated to the CountyACO that you reside in, unless otherwise stated

Title: Initial(s): First name: Surname:

Address (IN FULL):

Postcode:

Phone: Home: Mobile:

Email (important):

Date of birth: Ethnicity:

If you have any form of disability, special needs or medical conditions please give details:

Details of the course you are attending / attended - County: Dates:

Venue: Tutor:

Please tick as appropriate Umpire Scorer Both Active Non-active

County affiliation*:

Membership you are applying for, please tick your choice :

Full Member: payment method, D/D @ £30 / Chq @ £32. DBS required. Insurance provided

Associate Member: payment method, D/D @ £15 / Chq @ £17. No DBS. No insurance provided

Young Official (25 & under): payment method, D/D @ £15 / Chq @ £17. DBS required if 16 & over. Insurance provided

EC Member: payment method, D/D @ £30 (UK bank account only) / Chq @ £32. No DBS. Insurance provided

Overseas Member (non EC): payment method, D/D @ £15 (UK bank account only) / Chq @ £17. No DBS. No insurance provided

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ECB ACO Membership

ECB Offices

Warwickshire County Cricket Ground

Edgbaston

Birmingham

B5 7QX

Name(s) of Account Holder(s)

Bank / Building Society Account Number

Branch Sort Code

Instruction to your Bank / Building SocietyPlease pay England and Wales Cricket Board Ltd Direct Debits from the

account detailed in this instruction subject to the safeguards assured by

the Direct Debit Guarantee. I understand that the instruction may remain

with England and Wales Cricket Board Ltd and, if so, details will be

passed electronically to my Bank / Building Society.

Originator’s Identification No.

6 8 7 4 4 5

Instruction to your Bank or Building

Society to pay by Direct Debit

Name & full postal address of Bank / Building Soc.

To: The Manager Bank/Building Society

Address

Postcode

Signature(s)

ACO Membership Number

Date

Name

Banks and Building Societies may not accept Direct Debits from some types of account.

This guarantee should be detached and retained by the Payer.

perf

The Direct Debit Guarantee. This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits

. If there are any changes to the amount, date or frequency of your Direct Debit the England and Wales Cricket Association of Cricket

Officials will notify you ten working days in advance of your account being debited or as otherwise agreed. If you request the England and

Wales Cricket Association of Cricket Officials to collect a payment, confirmation of the amount and date will be given to you at the time of

the request.

. If an error is made in the payment of your Direct Debit by the England and Wales Cricket Association of Cricket Officials or your bank or

building society you are entitled to a full and immediate refund of the amount paid from your bank or building society.

. If you receive a refund you are not entitled to, you must pay it back when the England and Wales Cricket Association of Cricket Officials

asks you to.

. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required.

Please also notify us.

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