PLEASE PRINT OUT FOR COMPLETION

BOOKING FORM for 2001 NATIONAL

 

SURNAME:_______________________________ CHRISTIAN NAMES:____________________________
 

(preferred name)

ADDRESS:_________________________________ ______________________________________________
   
TOWN:___________________________________ POSTCODE:___________________________________
   
STATE/PROVINCE:________________________ COUNTRY:____________________________________
PHONE:  
HOME:(___)_______________________________ WORK:(___)___________________________________
   
MOBILE:_________________________________ EMAIL:_______________________________________
   
NO. OF PERSONS BOOKING:_______________  
   
OTHER NAMES IN GROUP BOOKING: SURNAME:____________CHRISTIAN NAMES:______
NB Full names please ______________________________________________
If more space needed, please use reverse of form ______________________________________________
   
NAMES OF ATTENDEES AS YOU WISH THEM TO APPEAR ON YOUR NAME TAGS
1.__________________________________________ 2._____________________________________________
3.__________________________________________ 4._____________________________________________
 
VEHICLE DETAILS:  
MAKE:_____________________________________ MODEL:________________________________________
DRIVER:____________________________________ COLOUR:_______________________________________
YEAR:______________________________________ REGISTRATION NO.:_____________________________
   
SPECIAL DIETARY REQUIREMENTS_________ ______________________________________________
   
DATES REQUIRED:  
ARRIVE:___________________________________ LEAVE:________________________________________
   

ROOM PREFERENCE:

Twin Share Units: Twin Bed Unit (__), Double Bed Unit (__), Family Unit (__)

Two Bedroom Apartments (__) (consisting of 2 double bedrooms, lounge/dining, kitchen and large bathroom) suit 3 to 4 guests.

FLOOR PREFERENCE: Ground (__), First (__), Second (__)

SATURDAY OPTION: Your Choice of morning or afternoon Surfers Paradise Canal Cruise (only available on Saturday) at $25.00 per person.

Please indicate your preference of either morning or afternoon: AM c OR PM c

Please Note: A deposit of A$35.00 per person accompanying this form will confirm your bookings.

TOTAL DEPOSIT ENCLOSED: A$___________________________________________

On receipt of your deposit and Booking Form you will receive your confirmation receipt.

Please return form to:

Mrs J. Clarke
9 St Petersburg Place
Nerang Qld 4211
Australia