Referee Examination Entry Form 2017
Reg. No / ClubTitle / First Name / Surname
Address
Post Code / Telephone
Preferred Course Leader/Area
Confirmation of CountyRegional/
District/SOG Approval
The minimum age for commencing training is 19yrs, subject to the candidate being aged at least 20yrs as at 4th November 2017 (the date of the exam). Candidates must have been qualified as Judge Level 2S with a minimum of 10 hours post qualification experience in that role. They must also have completed a minimum of 50 evidenced hours across all levels of officiating since the date of J2S qualification.
The course requires a considerable level of commitment from candidates who are required to undertake the following:-
· Attend a British Swimming Referee Course (approximately 16 hours theory)
· Complete the prescribed number of poolside duties (at least 10 Sessions practical)
· Attain a pass mark in the theoretical examination (2 hours 15mins)
· Complete a formal practical assessment
This form together with the examination fee of £15.00 (payable to British Swimming Ltd) to be sent to:
Mrs H Akers, 9 Three Tuns Road, Eastwood, Nottinghamshire, NG16 3EJ Tel: 07813 998519 to arrive no later than 31st December 2016.
Data Protection
The ASA/British Swimming will use your personal data for the purpose of your involvement as a licensed official and I understand that by completing this application I am consenting to receive information about the ASA/British Swimming by post, email, SMS/MMS, online or phone unless stated otherwise
I confirm that I am eligible for the British Swimming Referee training programme and have provided the evidence required. I enclose the fee of £15.00.
Signed………………………………………………………….Date………………………………..
Course Leaders for the British Swimming Referee Course
England
North East Mrs T Donnelly, Stanley
Mrs C Golightly, Bishop Auckland
Mrs E Johnson, Sheffield
Mr P Lilley, Sheffield
Mr F Murray, Newcastle upon Tyne
Mr R Perrell, Wakefield
Mrs S Prasad, Sheffield
Mr S Walker, Doncaster
Mr I Whitehead, Middlesbrough
Mrs E York, Newcastle upon Tyne
North West Mr D Broomhall, Crewe
Dr K Chisholm, Whitehaven
Mr M Davies, Sandbach
Mrs L Fawkes, Stockport
Mr G Whittle, Blackpool
Miss J Whittle, Blackpool
West Midland
Mrs S Carden, Leamington Spa
Mrs J Childs, Bridgnorth
Mr D Henderson, Telford
Mr S Highfield, Shrewsbury
Mr P Holmes, Wolverhampton
Mr R Jones, Oldbury
Mr I Lamb, Wolverhampton
Mr D Marsh, Walsall
Mrs H Summerill, Tamworth
Mr P Welsh, Warwick
East Midland Mr T Bream, Northampton
Mr R Brewin, Leicester
Miss J Highfield, Lincoln
Mrs L Kay, Nottingham
Mrs D Nicholas, Nottingham
Mrs E Sabin, Chesterfield
East Mr C Galer, Norwich
Mrs K McGuire, Grays
Mrs S Mackenzie, Sawbridgeworth
Mr D Metcalf, Bedford
Mrs G Metcalf, Bedford
Mr S Murray, Downham Market
Mr D Robinson, Bury St Edmunds
Mr S Tawn, Wisbech
London Mrs A van Beukelen, Worcester Park
Mr J Burdett, Dartford
Mr A Burton, Kingsbury
Mrs K Grimshaw, Lee
Mr T Oliver, Orpington
Mrs L Richards, Romford
Mr R Shortland, Feltham
Mr A Woska, Harrow
England (cont)
South East Mr G Adamson, Southampton
Ms S Ashton, Oxford
Mr I Bond, East Grinstead
Mrs J Davies, Sittingbourne
Mr R Drage, Worthing
Mrs S Green, Reading
Ms S Harrison, Eton
Mrs P Hogg, Guernsey
Mr C Jones, Oxford
Mr R Prior, Eton
Mr J Wilford, Milton Keynes
South West Mrs J Beard, Bournemouth
Mrs S Bryant, Bristol
Mr G Cockill, Shepton Mallet
Mrs M Davies, Truro
Mrs L Elliott, Saltash
Mr N Harper, Weston-super-Mare
Mr N Jenkin, Newquay
Mr R Moorhouse, Swindon
Mr A Smart, Broadstone
Mr A Withers, Street
Scotland
North Mrs K Cartwright, Calder, Caithness
Mr D Downie, Dyce, Aberdeen
Mr I Gibson, Kirkwall, Orkney
Mr B Hendry, Stonehaven, Kincardineshire
Mr K Paterson, Bridge of Don, Aberdeen
Midland Mrs P Thompson, Brechin, Angus
Mr E Wilmott, Carnoustie, Angus
East Mr R Ainslie, Cupar, Fife
Mrs J Maguire, Edinburgh
Mr A Shields, Haddington, East Lothian
West Mrs A Finlayson, Kilmarnock, Ayrshire
Mr T Mills, Kilmarnock, Ayrshire
Mrs J Morgan, Dean Park, Renfrew
Mrs B Murdoch, Prestwick, Ayrshire
Wales
North Mr C Clements, Mold, Clwyd
South Ms S Ashton, Llanelli, Carmarthenshire
Mrs E Edwards, Abergavenny, Monmouthshire
Mr C Jones, Llanelli, Carmarthenshire
13 September 2016