Nomination Form

Nomination Form – Night Roster

Your Details

First Name
Family Name
Phone (xx)xxxx xxxx or Mobile Number (04) xxxx xxxx
Address Line 1
Address Line 2
State or Region
Date of Birth
Gender of player

Nomination Information

What level did you last play at?
Nominating for division

When you nominate, the STBA will consider your grading performance (for new or returning players) or your previous division and performance in determining your placement.  This may mean you are sometimes moved up or down position or division.  The STBA will contact you if you cannot play in your nominated division.

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Terms and Conditions

Payment Details

One roster is $40, or you can pay for 3 consecutive rosters at a discounted cost of $105.

Payments can be made by Paypal or Credit Card following submission of this form, in person to the STBA Canteen or via direct debit/bank deposit.
For the latter please use "Rego" and your name as the Direct Deposit reference (eg. Rego J. Smythe) so that we know who the payment was from.

The STBA banking details are as follows:
Name: Southern Tas Badminton Assn
BSB: 067 002
Account: 2803 7309

If you need to make any notes about your payment, please provide them below:

Payment comments
Pre-paid for roster?
Online fee

Emergency Contact Details

First Name
Family Name
Phone (xx)xxxx xxxx or Mobile Number (04) xxxx xxxx

Parent/Guardian Information (if player is under 18)

If the nominating player is under 18 they need to provide the details of a parent or guardian.

Parent/Guardian Last name if player is under 18
Parent/Guardian Contact Number
Parent/Guardian Email

Any other information you wish to provide