Real
Australia Weekend
Registration Form
Please return this completed application form with fee to:
| Name | |
| Address | |
| Tel (hm) | |
| (work) | |
| (mobile) | |
| Full time $170 | $ | Part time Meals | |||||
| Part Time Accommodation (Please circle) | B |
L |
D |
||||
| $40 p.n. | Fr | $ | Fr | $ | |||
| Sa | $ | Sa | $ | ||||
| Su | $ | Su | $ | ||||
| Linen $17 | $ | Mon | $ | ||||
| Bed made $23 | $ | Registration $15 day |
$ | ||||
| Sub total #1 | $ | Sub total #2 |
$ | ||||
TOTAL #1 + #2 |
$ | ||||||
Payment details: Cheque □ Credit □ Exp _____________
Card # _____________________________________________
Name _____________________________________________
Signature _____________________________________________