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Ulysses 2020 Marlborough
Ulysses 2020 Marlborough Rally & AGM Registration Form
Name / Names *
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Membership Number/s for 1= 1234 for 2 12341234 *
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Branch select from drop down list *
Email Address *
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Registration/s @ $20 each if paid BEFORE 31.01.20 *
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Registration/s @ $30 each if paid AFTER 31.01.20 *
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Contact Phone Number *
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Membership Status *
Number of BOTH BADGES @ $12 (special price) enter zero if N/A *
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Number of Local Marlborough Badge @ $7 enter zero if N/A *
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Number of National 2020 Rally Badge @ $7 enter zero if N/A *
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Number of Friday night suppers @ $12 enter zero if N/A *
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Number of Saturday night meals @ $40 enter zero if N/A *
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Any special dietary requirements
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Number of Member Breakfasts Sunday @ $10 enter zero if N/A *
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Number of Non- Member Breakfasts Sunday @ $20 enter zero if N/A *
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Rally Polo Shirt @ $30
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2XL
3XL
Mens
Womens
Total Amount Paid (please check your arithmetic) *
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Paid via cheque in the mail?
Direct credited to 03-0599-0311074-01
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