Are you a Teacher or a Parent/Guardian of the Junior? * Teacher Parent/Guardian I am a Junior aged 13 or over Name of Submitter * E-mail Address or Phone Number of Submitter * We need to be able to contact you if there is a problem with your submission. This data will be destroyed as soon as your submission has been successfully processed. Bridge Teacher's Name * Teacher's EBU Number (if known) If the Teacher's EBU Number is provided, the certificate will be sent to the address they have registered with the EBU so they can present it to the junior. Award Level Achieved * MiniBridge Bronze Silver Gold Platinum Diamond Name of Junior * Junior's EBU Number Date of Birth * We need to know the Junior's Date of Birth in order to set up their free EBU membership until they are 26. If they are already a member of the EBU, please provide their EBU number above and this field will not be required. If you do not know their EBU number and would like to know it so that this field can be left blank, please contact David Emerson on 01296 317228 or at david@ebedcio.org.uk. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018 Contact E-mail * Having a contact e-mail address (can be a parent's or guardian's) helps us to stay in touch with the junior member. If you are not the owner of this e-mail address, they will be contacted for confirmation that they are happy for us to keep their e-mail address to be used in this way. Contact Phone Number Address If an address is supplied, the junior member will be sent a free Welcome Pack as a member of the English Bridge Union, if they are a new member. Address for Certificate Delivery (if different to that above) Data Protection Declaration * Please select the relevant option below. If any of the data being submitted does not belong to you or is not your responsibility as a parent or guardian of the junior, you must have express permission to share it with EBED. I have the junior's (acceptable if over 13) or the parent or guardian of the junior's (acceptable if under 18) express permission to share their details with EBED and for them to be used to contact the junior regarding bridge-related matters. They understand that they can revoke permission for this at any time by contacting EBED. I have the junior's (acceptable if over 13) or the parent or guardian of the junior's (acceptable if under 18) express permission to share their details with EBED, for a certificate and/or welcome pack to be sent to the address(es) above, and for them to be contacted to obtain express permission for EBED to use the data to contact them on an ongoing basis regarding bridge-related matters. I have the junior's (acceptable if over 13) or the parent or guardian of the junior's (acceptable if under 18) express permission to share their details with EBED and for a certificate and/or welcome pack to be sent to the address(es) above, but they do not give permission for the junior to be contacted by EBED in any other way. Data Protection Declaration * We would like to be able to stay in touch with you about junior bridge events and other bridge-related matters. Please select the relevant option below. I agree that the contact details provided may be used to contact me regarding bridge-related matters. I understand that I can revoke permission for this at any time by contacting EBED. Not all of the personal information I have provided on this page belongs to me. I give permission for EBED to contact the owner of the data to seek permission to use their data on an ongoing basis. I agree that a certificate and/or a welcome pack may be sent to the address(es) given above. I do not give permission for EBED to contact me in any other way. Data Protection Declaration * We would like to be able to stay in touch with the junior about junior bridge events and other bridge-related matters. Please select the relevant option below. I agree that the contact details provided may be used to contact the junior regarding bridge-related matters. I understand that I can revoke permission for this at any time by contacting EBED. I agree that a certificate and/or a welcome pack may be sent to the address(es) given above. I do not give permission for the junior to be contacted in any other way by EBED. Hall of Fame * We would like to add the junior's name to our online Hall of Fame for the recipients of our Junior Awards. Please confirm if you are happy for us to do this. I give consent for the junior's name to be listed on the EBED Junior Award Scheme Hall of Fame. I do not give consent for the junior's name to be listed on the EBED Junior Award Scheme Hall of Fame. Hall of Fame * We would like to add your name to our online Hall of Fame for the recipients of our Junior Awards. Please confirm if you are happy for us to do this. I give consent for my name to be listed on the EBED Junior Award Scheme Hall of Fame. I do not give consent for my name to be listed on the EBED Junior Award Scheme Hall of Fame. 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