The Capital Stamp Show 2015 Celebrating 150 years of Government in Wellington 23-25 October 2015, TSB Bank Arena, Wellington PO Box 2146, Wellington 6140, New Zealand Email [email protected] Website www.nzpf.org.nz/exhibitions/ ENTRY FORM Mr Mrs Ms Miss (‘X’ one) Dr Date of birth (youth only) [dd/mm/yyyy]: _______________ Family name: ___________________________ Given names : _____________________________________________ Address: __________________________________________ Phone: _______________________ __________________________________________ Email: __________________________________________ ___________________________________________ Title of exhibit: ____________________________________________________________________________________ Brief description for the catalogue (maximum 50 words) ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Class: ______________ If class 4.7, 5.1, 5.2, 5.3, 6.3 or 6.4 please enter discipline: _____________________________ [e.g.Thematic, Traditional, Postal History, etc] Number of frames required: _____________ This exhibit has received the following awards at previous National and International Exhibitions [most recent first]. Exhibition: __________________________________ Award: __________________ Points: ________ Exhibition: __________________________________ Award: __________________ Points: ________ Exhibition: __________________________________ Award: __________________ Points: ________ New Zealand resident entrants please answer a), b) and c) a) Is this your first or second multi-frame entry in a national exhibition? YES NO b) Are you eligible for the NZPF One-Frame Trophy (see regulation 21)? YES NO c) NZPF affiliated society/club of which you are a member: ____________________________________________ Fees NZ$ Payment Entry fee (see regulation 4) ______________ Cheque/bank draft payable to ‘Capital Stamp Show 2015’ Return Courier ______________ Internet banking/direct transfer ‘Capital Stamp Show 2015’ Donation ______________ Account No 38-9015-0755319-00 KiwiBank Enter family name / given name or initials in the particulars field. Total fees paid Overseas entrants forward entry form and payments through your Commissioner Method of delivery Commissioner Courier By hand Method of return Commissioner Courier By hand A draft title page MUST be attached. A synopis may also be submitted. The exhibit is my property and I have read and accept the Capital Stamp Show 2015 Exhibition Regulations. Exhibitor’s signature: _______________________________________________________ Date: __________________