FUFA Referees Registration Form Name *Name on passportEmail Address *Level of Eduction-- select --UCEUACECertificateDiplomaBachelorsMastersPhDO Level StudentPhone *Height (in CM e.g 178) *Gender *-- select --MaleFemaleDate of Birth *NIN *Region *-- select --Northern RFANorth East RFAWestnile RFABuganda RFAWestern RFAEastern RFAKitara RFAKampala RFASport *-- select --FootballFutsalBeach SoccerDistrict *-- select --BuikwebukomansimbiButambalaGombakalangalakalunguKassandaKayungaKibogaKyankwanziKyoteraLuweeroLwengoLyantondaMasakaMityanaMpigiMubendaMukonoNakasekeNakasongolaRakaiSsembabuleWakisoBuvumaDistrict *-- select --KabaroleBunyangabuKaseseBundibugyoKyenjojoKyegegwaKamwengeNtorokoBuliisaMasindiKikuubeHoimakagadikakumiroKibaaleKiryandongoDistrict *-- select --BushenyiibandaKabalekanungukisoroMbararantungamoRukungiriRubiriziRukigaKiruhuraIsingiroDistrict *-- select --BudakaBududaBugiriBusiaButalejaBuyendaIgangaJinjaKaliroKamuliKapchorwaManafwaMayugeMbaleNamayingoNamutumbaPalisaSironkoTororoDistrict *-- select --SOROTIMOROTOKATAKWIKABERAMAIDOAMURIANGORAKUMISEREREBUKEDEADistrict *-- select --KobokoAruaAdjumaniYumbeZomboTeregoNebbiDistrict *-- select --AgagoAlebtongoAmolatarAmuruApacDokoloGuluKitgumkoleKwaniaLamwoLiraNwoyaOmoroOtukeOyamPadhaDistrict *-- select --CentralKawempeMakindyaNakawaRubagaLeve of Referee *-- select --AssessorElite A (FIFA/Grade 1)Elite B (Grade 2)Grassroots (Grade 3 & Capacity building)Refereeing Status *-- select --ActiveRetiredInactiveYear of Qualification *-- select --20252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940Passport Photo *Choose FileNo file chosenDelete uploaded fileProfession (e.g Teacher etc) *Name of Next of Kin *Next of Kin PhoneAcc: No *Acc: Name *Bank Name *Refereeing Certificate *Choose FileNo file chosenDelete uploaded fileNational ID/PASSPORT *Choose FileNo file chosenDelete uploaded fileConsent *I confirm that I have read the FUFA Referees Practical Integrity Policy and that I will contact FUFA immediately in the event of any suspicious situations, contact or information.Status definationREGISTER
