2019 Sports and Club Class Nationals Entry Form

2019 Sports and Club Class Nationals Entry Form
Payment Details

Bank: ANZ
BSB: 014-630
Account Number: 101306463
Account Name: Kingaroy Soaring
Reference you used in the payment transaction
IMPORTANT - We need this to identify the payment as yours
Pilot Details
Pilots Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Your Gliding Club
GFA Membership Number
GFA Membership Expiry Date

DayMonthYear
Date
Next AFR Due

DayMonthYear
PLEASE NOTE Annual Flight Reviews will NOT be possible during the comp including practice days.
Emergency Contact Details
Name

First NameLast Name
Phone Number

Area CodePhone Number
Glider Details
Glider Type
VH Registration
Comp ID
Class Entering
Powerplant
- Second Pilots Name
  
  First NameLast Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Phone Number
  
  Area CodePhone Number
- Email
  example@example.com
- Your Gliding Club
- GFA Membership Number
- GFA Membership Expiry Date
  
  DayMonthYear
  Date
- Next AFR Due
  
  DayMonthYear
  PLEASE NOTE Annual Flight Reviews will NOT be possible during the comp including practice days.
- Emergency Contact Details
- Second Pilot Emergency Contact Name
  
  First NameLast Name
- Second Pilot Emergency Contact Phone Number
  
  Area CodePhone Number
- Should be Empty:

Pilot Details