National Coaching Conference 2007

Application Form

Please complete this form and send it together with payment to secure your place at the conference:

Scottish Squash, Caledonia House, 1 Redheughs Rigg, South Gyle, Edinburgh, EH12 9DQ

PLEASE USE BLOCK CAPITALS

1. Personal Details
Title: (Please delete as appropriate) Mr / Mrs / Miss / Ms / Other
Surname: Forename:
Address: Postcode:
Telephone: Telephone (Mobile):
Email Address: Occupation:
Date of Birth: Gender: Male / Female / Other
Are you registered as having a disability? Yes / No Please detail any requirements you may have:
What is your Ethnic Group? (for monitoring purposes only – please tick below)
Asian – Bangladeshi		Black – African		White – British		Mixed – White & Black Caribbean
Asian – Indian		Black – Caribbean		White – Irish		Any Other Mixed
Asian – Pakistani		Black – Other		White – Other		Other Ethnic Group
Asian – Other		Chinese		Mixed – White & Asian
Club Name(s):
Are you currently an Individual Competitive Member of Scottish Squash? Yes / No If yes, please insert your Scottish Squash Individual Competitive Membership Number:
Polo Shirt Size	S		M		L		XL
Please indicate if you have any specific dietary requirements

2. Please indicate with a tick which conference package you would like to purchase
£95 – Full Discounted Package For Individual Competitive Members Of Scottish Squash Entrance on both days, free Scottish Squash coaching membership, free delegate pack including polo shirt, speaker notes and goodie pack. Saturday and Sunday lunch. Saturday evening meal and networking.
£115 - Full Package For Non-Members Of Scottish Squash Entrance on both days, free Scottish Squash coaching membership, free delegate pack including polo shirt, speaker notes and extras. Saturday and Sunday lunch. Saturday evening meal and networking.
£65 - Package For Participants In The National League Finals Weekend For players participating in the National League Finals, subject to playing times. Free delegate pack including polo shirt, speaker notes and extras. Saturday evening meal and networking.
£30 – Optional Additional Friday Night Accommodation Single, en-suite room on campus at Heriot Watt University. Breakfast not included
£30 - Optional Additional Saturday Night Accommodation Single, en-suite room on campus at Heriot Watt University. Breakfast not included
Total	£

3. Payment Options, please tick
*Cheque	Bank Transfer
*UK cheques only, made payable to ‘Scottish Squash Limited’
For Bank Transfers, please transfer the relevant fee in sterling. You must accept all bank charges. Account Name: The Royal Bank Of Scotland Bank Address: Scottish Squash Ltd, South Gyle, Edinburgh Branch Account Number: 00 755 253 Sort Code: 83 19 04 IBAN: GB24RBOS83190400755253 IIBAN/SWIFT; RBOSGB2L

I enclose a cheque or confirm that I have transferred payment for £………. for my attendance at Scottish Squash’s National Coaching Conference on 14 -15 April 2007. Please note that cancellations will be subject to Scottish Squash Cancellation Policy. Applications for attendees under 18 years of age are advised to contact the office in the first instance.

Signed: ……………………………………………………………………………… Date: ………………………………………………………………………………….

Data Protection

The information on this form will be held in accordance with the Data Protection Act 1998. The data will be used for Scottish Squash administration purposes and grouped to provide statistical reports required by sportscotland and other relevant agencies.

Thank you for registering your attendance at the first Scottish Squash National Coaching Conference; we look forward to welcoming you there.

For information on ways you can support Scottish Squash, or for information on Scottish Squash visit www.scottishsquash.org or drop an email to info@scottishsquash.org