PFF-OPS-AFC-C-Certificate-F-0043

Pakistan Football Federation

Football House Opposite Punjab Football Stadium Feroz pur Road Lahore Ph:042-9230821-9230822 Fax : 042-9230823

AFC C Certificate Coaching Course Bio-Data Form

Coach Name: __________________________________________________________
Fathers Name: ________________________________________________________
NIC No: __________________________Blood group: _________________________

PHOTO

Date of Birth: ______________________Place of Birth: ________________________

Nationality: _______________________Religion: _____________________________
Passport No: ______________________Date of issue: ____________________ Expiry date: ______________
Place of issue: _________________________ Nearest Air port: ______________________________________
Gender: _________________________ Age: ___________________________ Occupation: _______________
E- mail address: _____________________ Address: _______________________________________________
_________________________________________________________________________________________
Mobile #: ______________ Office #: _______________ Residence #: _______________ Fax: _____________
Name of Club/Department: ___________________________________________________________________
Academic Qualification: _______________________ Sports Qualification:____________________________
(Tick it)
Computer Knowledge:
Basic
Intermediate
Advance
Language
English
Urdu
Other
English Reading:

Weak

Normal

Good

Fluent

English writing:

Weak

Normal

Good

Excellent

English spoken:
Weak
Normal
Good
Fluently
Playing Status : (Tick it) No or Yes (If yes, please provide the information and documents)
International National Provincial Department University District
Club
College

School

Write down:
Sr. #

Club/Dept

Session

Achievements

P.T.O

Coaching Status : (Tick it) No or Yes (If yes, please provide the information and documents)
International National Provincial Department University District
Club
College

School

Write down:
Sr. #

Club/Dept

Session

Achievements

Coaching Courses: (Tick it) No or Yes (If yes, please provide the information and documents)
International
National
Provincial
District
Refereeing Course Attend:
Sr. #

Course

Year

Instructors Name

Extra Skills: _______________________________________________________________________________

Intrest: ___________________________________________________________________________________
Measurements:
Height (CM)

Weight (KG)

Tracksuit

Jersey

Polo Shirt

Short

Shoes

Health Condition: (Tick it) Physical fitness certificate is attached

Medical Status
Medical History

Fit

Unfit

(Health condition, treatment, urgency and comments)

It is certified that the above mentioned informations are correct to the best of my knowledge.
_______________
Coach Signature
Recommendation by the General Secretary Provincial Football Referees Association
__________________________________
Signature with stamp General Secretary
Note:
1.
2.

Coaches bourn on 1st January 1984 or after is eligible to apply

Copies of Educational certificates are attached with copy of NIC, Passport (If available) and 4 Passport size
photographs send to PFF House.