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Sez Carnival 2015 Pre-Nomination Form
Sez Carnival 2015 Pre-Nomination Form
Pre - Nomination must be lodged with the South East Zone by Close of Business on the 25th of Septembe
All nominations are fully refundable if unable to attend.
Late nominations will incur a $20 per event fee.
FIRST
NAME
SURNAME
ADDRESS
SUBURB
STATE
CLUB
ACTA No.
CONTACT No.
AA
1.
2.
3.
4.
25
25
25
25
A
Tgt
Tgt
Tgt
Tgt
LADIES
VETERAN
JUNIOR
LADIES
JUNIOR
$16.00
$16.00
$16.00
$16.00
Handicap
Double Barrel
Single Barrel
Points Score
TOTAL
Payment Method:
CASH
CARD
CHEQUE
Signed:
Date:
TRAP CARNIVAL
R 9AM START
N FORM
ble to attend.
event fee.
POST CODE
HANDICAP
Date of birth
/
OPEN
$22.00
$22.00
$22.00
$22.00
MONEY ORDER
o
CLUB INC.
Zone Rules.
te. ( www.factc.com.au )
Date Received