Q MEET FILL OUT FORM

QMeet18 – Expression of Interest Form

Please Note:

All Fields With An Asterisk Are Compulsory To Fill Out, Otherwise I Will Not Receive Your Information.

Members Attending (Number) *

Name 1 *

Name 1

Please Fill In First Name And Surname Please

First Name

Last Name

Shirt Size Name 1 *

Name 2 *

Name 2

Please Fill In First Name And Surname Please

First Name

Last Name

Shirt Size Name 2 *

Your Email Address *

Mobile Phone Number Or Home Number *

MX5 Registration Number *

MX5 Year Of Manufacture *

MX5 Model Number *

INFORMATION

We will be providing you with a QMeet18 number linked to your MX5. Please quote this number in all payments or correspondence. Accommodation is available in either one or two bedroom apartments. You may prearrange your share accommodation with another club member or you may ask us to arrange share accommodation for you. Please put a cross in the box which best suits your needs. If you have sorted your own sharing arrangements please insert the name of the person/couple in the box provided.

Apartment Options *

* Option 1 BRM Apartment * Option 2 BRM Apartment - Share Arranged With : * Option 3 BRM Apartment - Please Arrange Sharing Details For Me

We will inform the hotel of your booking arrangements and let you know when this has been finalised, in order that you can pay the deposit required to confirm your hotel booking. The total cost of attending QMeet18 is $270.00 per person. The deposit is required to be paid in two parts. $135.00 is due by 31 October 2017 $135.00 is due by 31 March 2018 When processing your deposit please quote your QMeet18 number. Payment may be made by transfer or deposit to the: Bendigo Bank BSB: 633-000 Account: 1611 11406 Once you have completed your transfer please return it by Clicking the Submit Button Which Will go directly To My Email Address, To Confirm.

Message

Any Questions, Please Ask