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1. Name

Name

*

2. Gender

MaleFemale

Gender

*

3. Institution

Aberdeen UniAbertayDundeeEdinburghGlasgowGCUHeriot-WattNapierQMURGUSACSt AndrewsStirlingStrathclydeUHIUWSOther/ non-student

Institution

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4. Which course do you wish to attend?

Basketball Scotland Level 1 referee courseSFA Entrance Level Football Referee courseScottish Hockey C badge Umpire CourseSRU Level 1 Rugby Referee & Touch Judge course

Which course do you wish to attend?

5. If a current student please indicate when you intend to graduate

20122013201420152016

If a current student please indicate when you intend to graduate

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6. Address

Address

*

7. E-mail address (please note this will not be shared with third parties)

E-mail address (please note this will not be shared with third parties)

*

8. Mobile phone number (please note this will not be shared with third parties)

Mobile phone number (please note this will not be shared with third parties)

*

9. T-shirt size

Ladies x-sLadies sLadies mLadies lLadies xlMen's xsMen's sMen's mMen's lMen's xl

T-shirt size

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10. Do you require accommodation during the event?

	yes	no
Fri 4th Nov	*Do you require accommodation during the event? Fri 4th Nov yes	Fri 4th Nov no
Sat 5th Nov	Sat 5th Nov yes	Sat 5th Nov no

11. If you have any special dietary requirements, please note these below

If you have any special dietary requirements, please note these below