Competitor Name Letters) (First Name) (Surname) Mailing Address Suburb // Date of Birth Postcode State (Compulsory) Home Phone Mobile Phone Email Home Club GOLFLink GA Handicap Number Amputee Above Elbow Below Elbow Above Knee Below Knee Multi Other Status Amputee Golf Association Q.A.G.A A.G. NSW A.G Vic S.A A.G.A Please Specify (Required) Please circle All events you will be attending Sat 12th Sun 13th Sun 13th Sun 13th Events Round 1 Round 2 Pres. Dinner Pres Dinner Only Shirt Size S M L XL XXL 3XL 4XL Women Please Specify Amputee Entry Fee: Includes two Rounds of Golf, Lunch & Presentation Dinner; $200 Single accommodation rate: $300, Non Golfer Accom. $320 Please use your name as a reference when using Electronic Funds Transfer. Forward Payment to Amputee Golf NSW Incorporated; BSB 032-069 Acc. No. 184 131
Competitor Name Letters) (First Name) (Surname) Mailing Address Suburb State Postcode Date of Birth (Compulsory) // Home Phone Mobile Phone Email Home Club GOLFLink Number GA Handicap Amputee Status Above Elbow Below Elbow Above Knee Below Knee Multi Other Amputee Golf Association (Required) Q.A.G.A A.G. NSW A.G Vic S.A A.G.A Please Specify Events Round 1 Round 2 Pres. Dinner Pres Dinner Only Please circle All events you will be attending Sat 12th Sun 13th Sun 13th Sun 13th Shirt Size S M L XL XXL 3XL 4XL Women Please Specify Amputee Entry Fee: Includes two Rounds of Golf, Lunch & Presentation Dinner; $200 Single accommodation rate: $300, Non Golfer Accom. $320 Please use your name as a reference when using Electronic Funds Transfer. Forward Payment to Amputee Golf NSW Incorporated; BSB 032-069 Acc. No. 184 131
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