2015 Coral Reunion Registration Form
!
Please complete all details so we can check our records and produce new name tags for newcomers/lost tags
All personal details will be treated confidentially and used only for distribution of Coral Reunion information and for other Coral Reunion Members’
enquiries. (It will only take you 1 minute to complete this Form BUT it will certainly help us a great deal…THANKS. Pepe.) !
Surname of Vet Attendee ………………………………………………… First name ………………………
Preferred name or nickname……………………………………………… Army Service No ……………….
Sub Unit (e.g. 3 Pl A Coy) ………………….. & Unit …………………………………………
Address
…………………………………………………………………………………………..State. ……P/c. …….
Mobile Phone. . . . . . . . . . . . . . …. E-mail (write clearly)…………………………………………………………………
1st & last name/s of accompanying person(s): ……………………………………………………………….
…………………………………………………………………………………………………………………..
I’m staying at Accommodation: ………………………………………………………………………..……
Reunion Name Tag? Do you have one: YES / NO.
I also need one for:………………………………………………………………………………………….…
I/ We (circle) have a special dietary need which is: ……………………………………………………………
……………………………………………….. Please provide a suitable alternative meal/s to take this into account. Thank you.
!
Payment Details: I include payment for my/our Dinner Registration, Raffle ticket/s, Bus trip.
$165Couple incl 2 Raffle $5 tickets or $85 Single incl 1 Raffle ticket plus $ ____for the bus & extra tickets
YES / NO. I will pay direct through Bank Electronic Transfer to the Reunion Account which is:
St George Bank BSB 112-908 A/c 02103134. You must indicate your ‘Name’ & incl ‘Coral’
YES / NO. I will pay with a Cheque/ Money Order made out only to “Coral Reunion”. see attached.
The payment amount I’m sending/transferring TOTALS: $ .......................
Register of interest in the trip to Singleton Museum and /or Winery on Sunday
YES / NO : I wish to reserve (Qty) …. seats for the 9.00am Singleton Museum & Winery tour ..Cost $24/h
YES / NO : I wish to reserve (Qty) …. seats for the 9.30am Singleton Museum only tour …Cost $24/h
Includes $4 entry to Museum
Please Send this to:
Ray Curtis 7/9 Coral drive , Jerrabomberra Heights, NSW 2619
He will send a Receipt to you.
If you have NOT received a Receipt within 4 weeks after sending, then Phone or Email Ray to fix it.
Ph. 02 6255 9426 Email: rosandray4@bigpond.com
Thank You.
