Academy Trial Application

If you wish to be considered for a trial please complete the following form:

Christian name:

Middle names:

Surname:

Date of birth:

Nationality:

Height:

Weight:

Are you currently registered with a club? 
YES    NO

If yes, which club:

Are you currently represented by an agent?  
YES     NO

If yes, please give the agent's name and company:

Please list the last 3 clubs you have played for:
1. Club name:                                     Release date:

2. Club name:                                     Release date:

3. Club name:                                     Release date:

Most recent club coach name:

Contact telephone number for last coach:

Any loan spells:

Referring to the diagram above, please list your primary position number?

Referring to the diagram above please list what other position numbers you have played in?

Are you currently at university?  
YES     NO

If yes, which university:

Graduation date:

Current address:

Contact mobile telephone number:

Contact home telephone number:

Email address:

The GHA will retain your information, whether you are successful obtaining a trial or not, in case we can support your footballing career with our partner organisations.