2016/17 National 4’s Title Nomination Form

VENUE & HOST CLUB:: Mothar Mountain Speedway – Gympie Saloon Car Club Ltd

DATE: 4th March 2017

TOTAL NOMINATION/ADMIN FEE: $70 incl GST (NON REFUNDABLE) incl Transponder Hire
TOTAL LATE NOMINATION FEE: $200 incl GST (NON REFUNDABLE) incl Transponder Hire

NOMINATIONS CLOSE: Friday, 24th February 2017

NOMINATION FORM TO BE RETURNED TO: Kaye Arthur – Title Co-Ordinator, Speedway Sedans Qld, P.O. Box 513, HERVEY BAY  Q  4655   Mobile 0408 766 651

Email:  secretary@qsca.com.au

(Faxed/emailed entries with payment via credit/debit card are acceptable – faxed/emailed entries with other means of payment MUST be followed up with the original 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/debit card details

FORMAT: Refer to full information sheet and nomination form for more details.

Click here to open the 2016/17 National 4’s Nomination Form and Driver information in Adobe PDF Format – 477 KB – to print (or right mouse click and select “Save Target As” to save the document to your PC).