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Referee Availability Form
Form Submission Number
This form should be used to submit your availability for all competitions you wish to officiate in for season 2022/23 for leagues and competitions FA sanctioned within the West Riding County FA. Please Note : The third weekend of the month is District FA conference dates. It is a West Riding County FA mandate on District Cup competitions to close any dates with your regular League/Competition when accepting an appointment. This will be administered online by leedsfa.pitchsiderefs.co.uk password is by FAN number once your form is received and details entered exclusive to the Leeds & District Football Association. Fields marked * are mandatory fields.
Referee Contact Details
Full Name
*
This should be your FIRST NAME and SURNAME
Email Address
*
This is the default email address that will be used to communicate with you.
Phone Number
*
This number will be used to communicate with you.
Referees FA Number
*
Referee Age Range
*
Under 25
Age 25-45
Age 45-65
Over 65
Referee Level
*
Level 0
Level 1
Level 2a
Level 2b
Level 3
Level 4
Level 5
Level 6
Level 7
Youth Registered Referee
Training
Developer
Mini Soccer Only
Club Only Home Appointments
Do you have a current CRC ?
*
The FA requires those working in eligible* roles with children and young people to pass a criminal records check.
Yes
No
Do you have a current Safeguarding Children Certificate ?
*
The FA requires those working in eligible* roles with children and young people to hold a current Safeguarding Children Certificate.
Yes
No
Number of Years as Referee ?
Move the slider to indicate the number of years you have been a referee.
If you have refereed for 2 years or less, do you require a mentor?
*
Yes
No
Are you applying for promotion in the coming season?
*
Yes
No
Are you a member of the Leeds Referee's Association (Leeds RA)?
*
Yes
No
Do you have private transport?
*
Yes
No
Maximum distance you wish to travel (radius in miles) ?
Move the slider to indicate the maximum number of miles you are prepared to travel.
Which League/Competitions do you normally officiate in or intend to for 2022/23 season ?
*
Select the league/s you will be applying to officiate in for 2022/23 Season. Click on the down arrow to display a list of leagues. Click and select league. Click on the Add icon to select more than one league.
Which Leeds & District FA Competitions would you like to officiate in?
*
Select All
Open-Age Saturday (2pm / 3pm)
Open-Age Sunday (11am)
Juniors Sunday (2pm)
Are you available for West Riding County FA Cup competitions if required on County FA Conference dates ?
*
Yes
No
Are you available for University midweek afternoon fixtures?
*
Yes
No
Are you available for end-of-season midweek fixtures?
*
Yes
No
Please confirm that you agree with the Leeds FA GDPR policy
*
View the Leeds FA GDPR Policy
Yes
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