COLLEGES AND UNIVERSITIES MEMBERSHIP Anglesey Cardiff Denbighshire Monmouthshire Powys Vale of Glamorgan Blaenau Gwent Carmarthenshire Flintshire Neath Port Talbot Rhondda Cynon Taff Wrexham Local Authority Bridgend Ceredigion Gwynedd Newport Swansea Caerphilly Conwy Merthyr Tydfil Pembrokeshire Torfaen Name of Institution Address Postcode Phone Number Contact name Email Address Type of Institution College Number of players Junior (Under 19 on 1st September 2014) Senior Total University Female Male Annual Membership for Colleges/ Universities - £50 Please submit this form to Badminton Wales via email to Rob.Short@badminton.wales or via post to the following address: FAO Rob Short, Badminton Wales, Sport Wales National Centre, Sophia Gardens, Cardiff, CF11 9SW. Please select the appropriate payment option below: Payment by Bank transfer Bank: Lloyds Bank, Queen Street, Cardiff Account Number: 02529177 Sort Code: 30-96-91 Payment by cheque Please make cheques payable to ‘WBU Ltd’ or ‘Badminton Wales’ If you are a college or university where players wish to play in Welsh Satellite Series (WSS) events, please provide the player information requested overleaf so that they are not charged an affiliation fee and can merely pay the entry fee for the tournament. Additionally, if you are a University which plans to enter the Welsh University Cup, please list any player who could potentially participate in the event (team, reserves etc). First Name Surname Gender (M/F) DOB Email Address