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1 England and Wales Cricket Board Application for Registration as an Agent Lord s Cricket Ground London NW8 8QZ Tel: Fax: agents@ecb.co.uk Surname... Other names... Address Post Code... Phone number/s... address... Date and place (including country) of birth... Nationality... Occupation Professional qualifications Under what name do you trade as an agent?... Employer or Company for whom you provide services (as an agent) as applicable... Registered Office address (if different from above)....post Code.. Co number..vat Registration no Are you a director?...please list other directorships... Names of other directors/partners in agency business. How many employees does the business have?... Do you have any other trade, profession, employment or business interests (above a 5% shareholding in a listed company) please list.. Employment History Please provide details of your employment history since leaving full time education and give an explanation if there are significant gaps in your employment during this period. Dates From/To Employment
2 Reputation and Character Please answer the following questions: 1. Have you been convicted of any offence involving dishonesty or deception? Yes No 2. Have any proceedings been instituted against you for an offence of dishonesty or deception which have not yet been concluded? 3. Are you an undischarged bankrupt or has any award been made for the sequestration of your estate which remains undischarged? 4. Has any petition been presented to the court for an order adjudging you bankrupt, or for the sequestration of your estate, for which proceedings have not yet been concluded? 5. Have you been disqualified from acting as director of, or otherwise being involved with, a company by an order under the Company Directors Disqualification Act 1986 (or any analogous overseas legislation)? 6. Has any application been made to the court for an order disqualifying you from acting as a director of, or otherwise being involved with, a company for which proceedings have not yet been concluded? 7. Are you subject to an order under Section 429(2)(b) of the Insolvency Act 1986 (or any analogous overseas legislation) as a result of having failed to make payments required by an administration order? 8. Have you at any time in the previous ten years been refused or had revoked membership of any professional body of which you have been, or have applied to be a member? 9. Are you an officer, employee or consultant of a First Class County or the ECB (including without limitation a current registered and/or contracted cricketer), or any person in an official position with the ECB?
3 10. Have you been censured or disciplined in the UK or overseas in the previous ten years by any organisation in relation to your business or professional activities? 11. Do you have any formal or informal business or commercial relationship with a bookmaker or other concern offering gaming facilities of any kind? 12. Are you currently undergoing any investigation or disciplinary procedure by any organisation or authority? If you have answered Yes to any of the above, please provide details:... NB: Any false or misleading answer or information provided in this application may lead to your application being refused or, if registration has already been granted, the cancellation or suspension of your registration. Client details Please provide the following details in respect of all your cricket clients (all information provided will be kept strictly private and confidential by the ECB/PCA and only viewed by authorised personnel and any data used for statistical analysis will be anonymised): In the following order Name, County, years left on contract, salary bracket (to the nearest 10,000.00) and personal sponsorships (name of sponsor only):. (Please continue on a separate sheet if necessary) Undertakings I hereby undertake and confirm that I will abide by the Rules, Regulations, Directives and Resolutions of the England and Wales Cricket Board as amended from time to time and acknowledge that I have seen and read: a the Regulations Governing the Qualification and Registration of Cricketers and the Regulations Defining Qualification for England; and b the Cricket Discipline Commission Regulations; and c the Directives of ECB; and d the Clothing and Equipment Regulations; and e the Players Agents Registration Regulations; and f the ECB Anti-Doping Rules and the ECB Illicit Drugs Policy; and g. the ECB Anti-Corruption Code; and
4 h. the ECB Minimum Standards for Players and Match Officials Areas i. the ECB/PCA Standard Player Contract; and j the ECB contract of employment for England Centrally Contracted Cricketers (if you have an England Centrally Contracted player client/s). I acknowledge that my continuing registration as an agent is dependent upon adherence to ECB s Rules, Regulations, Directives and Resolutions and attendance at least one ECB Agents meeting in each year (if one or more are scheduled by ECB) and on passing the registration entrance examination and any other periodic questionnaire or test set in the future at the ECB s entire discretion. I hereby undertake that if I do not use the standard ECB/PCA form of agency contract, I will recommend any cricketer who signs an agency contract with me to consult the PCA about the form of the contract and will in any event provide for the unconditional right of the cricketer to terminate his contract with me if my registration as an agent with ECB is cancelled. I will provide a copy, attached to this application, to the PCA of my standard form of client contract if I do not use the ECB/PCA standard form of agency contract. In accordance with clauses 4.1(i) and 4.3 of the ECB Players Agent Registration Regulations, I hereby warrant that I am covered by an appropriate professional liability insurance policy to a minimum of 500, per claim against the possibility of a claim against me in relation to my cricket agency activities and append a copy of the certificate of insurance to this application. I declare that the information supplied is complete and correct and that I will inform ECB/PCA immediately of any changes to the information provided in this application, in particular any additions to or deletions from my client list or significant changes in my business that may, directly or indirectly affect my relationship with my clients or the terms on which I do business as a cricket agent. For the above purposes, until further notice, I will submit all information and updates to information without delay to Ian Smith, PCA Legal Director, at The Professional Cricketers Association, The Laker Stand, Kia Oval, London, SE11 5SS PLEASE ATTACH A PASSPORT STYLE PHOTOGRAPH AND A.jpg FORMAT COPY TO ismith@thepca.co.uk THE CURRENT REGISTRATION FEE IS: VAT PLEASE ENCLOSE A CHEQUE MADE OUT TO Professional Cricketers Association OR MAKE AN ELECTRONIC TRANSFER TO PCA Management Limited Account Account Name Sort Code Account No IBAN BIC Address PCA Management Limited GB92NWBK NWBKGB2L National Westminster Bank Plc Charing Cross, London Branch PO Box 113 Cavell House 2a Charing Cross Road London WC2H 0PD Data Protection Act The England and Wales Cricket Board (ECB) and the Professional Cricketers Association (PCA) will use your personal information (whether obtained via this application form or otherwise) for the purpose of administration and management, statistical analysis, approving or rejecting your application, disciplinary proceedings (including investigating allegations of misconduct and cancelling approved registrations), managing contact between agencies, players and counties, creating a public register and notifying you of any relevant changes or updates (eg to regulations). If your application is approved, your name, the name of
5 your organisation and other limited information about you (eg contact details) will be included within a register that will be made available to counties, players and the general public anywhere in the world. We may also disclose your personal information to other National Governing Bodies (which may be located outside the European Union) and/or the International Cricket Council (ICC) for any of the purposes described above. If your application is not successful, we will retain a copy of your information on file in case you wish to appeal the decision and/or for our internal administration and management purposes. By signing and returning this form you consent to your personal information (including information about your criminal convictions) being used and disclosed as described in this section and you consent to the transfer of your personal information to countries outside the European Union where necessary in order for the ECB/PCA to work with other National Governing Bodies or in connection with the public register. You have the right to request a copy of any personal data which the ECB/PCA may process about you, subject to the payment of a small fee, and to correct any inaccuracies in your information. Signed... Date:... Confirmation of Registration: Exam Passed: YES/NO date of exam: I confirm that the Registration has been accepted: For the ECB... Date:...
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