Entry Form - All Ford Day

Transcription

Entry Form - All Ford Day
18th September 2016
Bonython Park
Port Road
Adelaide, SA
www.allfordday.net.au
Entry Director: 0475 916 421
Event Director: 0402 965 154
PO BOX 1003
Prospect East, SA 5082
Entry Form
Entrant Details:
Name:
Address:
Suburb:
State:
Tel-Home:
Tel-Mobile:
Postcode:
E-mail address:
Y/N
Member of Club:
Club Name:
Vehicle Details:
Display Areas:
Model:
Falcon XK - XP
J01 Falcon XK - XP
Year:
Falcon XR - XT
J02 Falcon XR - XT
Reg No:
Falcon XW - XY
J03 Falcon XW - XY
Falcon XA - XC
J04 Falcon XA - XC
Y/N
Vehicle to be judged:
(If Yes) Judging Category
(select only one)
Judging Categories:
Falcon XD - XF
J05 Falcon XD - XF
Area or Club Display:
If additional space for your individual display is required please indicate below.
Please note the organisers will try to accommodate all requests but will use their
own discretion when allocating areas.
Falcon EA - EL
J06 Falcon EA - EL
Falcon AU - BA - BF
J07 Falcon AU - BA - BF
Falcon FG - FG-X
J08 Falcon FG - FG-X
TotalAreaRequested
Tickford
J09 GT Falcon XR - XY
FPV
J10 GT Falcon XA - XB
_______X_______M
Entries:
Falcon Coupe
J11 GT Falcon EB - EL
Mustang (Steel bumper)
J12 FPV GT BA - BF
Mustang (Plastic bumper)
J13 FPV GT FG
Thunderbird
J14 Tickford (not GT)
F-Series / Commercial
J15 FPV (not GT)
SUV
J16 Coupe / Cobra / Landau
Entries submitted after 19th August 2016 are subject to a $10 surcharge per
vehicle.
Fairlane / Galaxie / LTD
J17 Mustang (Steel bumper)
Multiple vehicle entries must have the same owner to be eligible for discount.
Customline / Victoria
J18 Mustang (Plastic bumper)
Model T
J19 Customline / Victoria
Model A
J20 Thunderbird
Early Side Valve
J21 F-Series / Commercial / SUV
Amount
Entry Fee - Single Vehicle
Total
$30.00
Entry Fee - Additional vehicles (each vehicle on
separate form to be attached - only 1 payment
required)
$25.00 /
vehicle
Payment Options:
Credit Card Payment
Card Type: (Please circle)
8 & 10HP Side Valve
J22 Fairlane / Galaxie / LTD
Card No:
VISA / MASTERCARD
Anglia / Prefect
J23 Sports Car (Pantera / GT40 / Cobra)
Card Holder Name:
Capri (pre 1986)
J24 Model T
Cortina
J25 Model A
Signature:
Escort
J26 Early Side Valve
CreditCardPayment(bycompletingdetailsyouareauthorisingpayment)
Fiesta / Focus / Mondeo
J27 8 & 10HP Side Valve
Other Small Fords
J28 Anglia / Prefect
Sports Cars
J29 Capri (pre 1986)
Zephyr / Zodiac / Consul
J30 Cortina
Hot Rod / Highly Modified
J31 Escort
Ute (Steel bumper)
J32 Fiesta / Focus / Mondeo
AllFordDay
Ute (Plastic bumper)
Other Small Ford
J33 (inc. Laser / Late model Capri)
AllFordDay
Other Fords
J34 Hot Rod (Ford powered)
Expiry:
/
allforddaysa@gmail.com
PayPal Account:
Please include entrants name and vehicle registration details under reference
Cheques / Money Orders:
Make all payable to:
Send form and payment to:
POBox1003
J35 Zephyr / Zodiac / Consul
ProspectEast,SA5082
J36 Iron Maiden **
J37 Original / Unrestored
In the past we have been asked by various car magazines for names of vehicle
owners so that they can be credited alongside pictures of their vehicle that are
published.
Do you give permission for All Ford Day to release your name for
publication alongside a picture of your car?
J38 Ute (Steel bumper)
J39 Ute (Plastic bumper)
Y/N
J40 Highly Modified / Street machine
J41 Any other Ford vehicle
Signature of Entrant:
Date: