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Kilcoy Pastoral, Agricultural and Industrial Society
Kilcoy Show Society
17- 18,h APRIL 2015
Entertainment Agreement
We wish to invite you to fulfil an Appointment for the Kilcoy PA & I Society.
Contact Details
Name:
Address:
Suburb:
Postcode:
Phone:
Fax:
Mobile:
Email:
Additional Person Accompanying □ Yes □ No
FOR KILCOY SHOW 2015
Section / Category:
All Areas as per discussion with Trevor Wessling
Date
Time Starting:
Costs covered by Kilcoy PA & I Society (to be negotiated & ratified through Executive)
Will be paid by
DIRECT DEBIT INTO YOUR ACCOUNT.
Fee
Please advise you bank details.
We thank you for the valuable contribution that you will make to our 2015 Show.
Office Use Only
Number of Admission Tickets issued
___________________________
_______________
Date
 Yes
Sent:
Total Amount: $ __________
______________________
Show Society Representative
Signature
____________
Date
Kilcoy Show Society contact
07 5497 2149 / 0488798882
Date Paid:
____________
Signature:
____________
T A M