QuickTimeTM and a decompressor are needed to see this picture. The document is an enrollment form for the Duke of Edinburgh's Award, where a participant can enroll at Bronze, Silver, or Gold level. It requires signatures from both the participant and parent/guardian to agree to taking part.
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Notts acf enrolment_form dofe
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Nottinghamshire ACF
THE DUKE OF EDINBURGH¡¯S AWARD
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Application for Enrolment
Please complete form in Block Capitals
Unit: Detachment: ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡..
DofE Group Leader: ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡
Name: ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡
Gender: MALE / FEMALE Date of Birth: ¡¡¡../¡¡¡../19¡¡¡..
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Address: ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡..
¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡...¡¡¡ Postcode: ¡¡¡¡¡¡¡¡¡
Home Telephone: ¡¡¡¡¡¡¡¡¡¡¡ Mobile: ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡
Email: ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡..
Do you consider yourself to have a special need? YES / NO
Special Needs:
Which Level are you applying for: Cost Please tick
I wish to enter at BRONZE level (minimum age 13yrs 9 mths) ?14.00 (already paid for on
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entry to Notts ACF if joined
after Jan 09)
I wish to enter at SILVER level (minimum age 15 yrs)
I have almost completed Bronze level ?14.00
I wish to enter at SILVER DIRECT (minimum age 15 yrs)
I have not completed Bronze ?14.00
I wish to enter at GOLD level (minimum age 16 yrs)
I have/almost completed Silver level ?20.00
I wish to enter at GOLD DIRECT (minimum age 16 yrs) ?20.00
Please hand in the correct money or cheque to your Unit Leader. Cheques should be made payable to:
Nottinghamshire ACF
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This section to be completed by Parent/Guardian please
I have read all details and agree to my *son/daughter/ward taking part in the Duke of
Candidate to Sign (*please ¡¡¡¡¡¡¡¡¡¡¡¡¡..¡¡¡¡. Date: ¡¡¡¡¡..
Edinburgh¡¯s Award here: delete as necessary)
Signed (*Parent/guardian): ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡. Date: ¡¡¡¡¡¡¡
Remember to make cheques payable to
Nottinghamshire ACF
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decom pressor
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This section to be completed by Parent/Guardian please
I have read all details and agree to my *son/daughter/ward taking part in the Duke of
Candidate to Sign (*please ¡¡¡¡¡¡¡¡¡¡¡¡¡..¡¡¡¡. Date: ¡¡¡¡¡..
Edinburgh¡¯s Award here: delete as necessary)
Signed (*Parent/guardian): ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡. Date: ¡¡¡¡¡¡¡
Remember to make cheques payable to
Nottinghamshire ACF
6. Qui ckTim e? and a
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This section to be completed by Parent/Guardian please
I have read all details and agree to my *son/daughter/ward taking part in the Duke of
Candidate to Sign (*please ¡¡¡¡¡¡¡¡¡¡¡¡¡..¡¡¡¡. Date: ¡¡¡¡¡..
Edinburgh¡¯s Award here: delete as necessary)
Signed (*Parent/guardian): ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡. Date: ¡¡¡¡¡¡¡
Remember to make cheques payable to
Nottinghamshire ACF