The Rotary Club of
Portsmouth North Golf Day
4th June 2015
Our Main Sponsor
12 Livingstone Road,
Southsea,
Hants.
PO5 1RT
Mob:- 07926 072371
Home:- 02392 818755
Email:- [email protected]
TEAM ENTRY FORM
I would like to enter (no) ……… Team (s) @ £300.00 per Team Total £……………………………………..
VIP Package Range Rover Chauffeur Team Collection & Return with Wine on Table add £200 (per team)
You will be contacted for your team collection and return points etc.
(Limited availability)
My full Name and Address (contact for all future correspondences)
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Tel:-............................................................... Mobile:-…………………………………………..
Email:-…………………………………………………………………………………………………
Your Team Name (s) ………………………………………………………………………………..
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I Enclose A Cheque for ………………….* payable to The Rotary Club of Portsmouth North
Or for BACS Payments Lloyds Bank Account No 00613958 Sort Code 30-96-11
Post this form with payment to Chris Fairhall 12 Livingstone Road, Southsea PO5 1RT
Or If BACS payment you can email the form to [email protected]
*If you require an invoice to raise a payment please phone or email me and I will sent it out but please
return this form to reserve your team place.
I will acknowledge with a receipt for all payments made.
(Sorry no card payments)