2010/11 4 Cyl Sedan Title Nomination Form
2010/11 STATE 4 CYLINDER SEDAN TITLE
VENUE: Mothar
Mountain Speedway
DATE: 12th February, 2011 - One Night Only
HOST CLUB: Gympie Saloon Car Club
TOTAL NOMINATION/ADMIN
FEE: $100 incl GST (NON REFUNDABLE)
incl Transponder Hire
TOTAL NOMINATION/ADMIN FEE: $85 incl
GST (NON REFUNDABLE) with your own Transponder
TOTAL LATE NOMINATION FEE: $230 incl
GST (NON REFUNDABLE) incl Transponder Hire
NOMINATIONS CLOSE: Friday, 14th January, 2011
NOMINATION FORM TO BE RETURNED TO: Title Co-Ordinator, QSCA Inc,
P.O. Box 1032, COOLUM BEACH 4573 Mob: 0411 475 603 Fax: 5471
6277
(Faxed entries MUST be followed up with the original and cheque by mail, and received within 7 days, or a late nomination fee will be levied).
Cheques/Money Orders to be made payable to: QSCA Inc or credit card details
FORMAT: Refer to full information sheet and nomination form for more details.
