1. Shropshire Rugby Conference 2017
Application Form
Book Volunteer Sessions
Safeguarding
First Aid 6 hours
Tick one box
Name
Address
Postcode
Tel
Club/School and
Age Group coached
Special Requirements
(diet/disability etc)
Polo shirt size
S M L XL XXL XXXL (Please circle appropriate)
Book Rugby Sessions
Session 1
Session 2
Choose 1 of A, B, C, D or E for session 1.
Choose 1 of F, G H or I for session 2 .
Put one letter in each box
Payment by bank transfer to
Royal Bank of Scotland
Sort code
Account No
Please quote your name in reference box
Cheque made payable to SRDG
Please return cheque and application form to
Rae Evans, 28 Porthill Drive,
Shrewsbury, Shropshire
SY3 8RS
£30
Inc VAT