Gold Coast Bridge Congress

5 ENTRY FORM Contact Information Contact details for this entry and the Gold Coast Congress mailing list. Payment Options Direct Deposit BSB: 484-799 Acc No: 452338505 Name: QBA Cheques payable to Queensland Bridge Association Inc Credit Card Complete details below Name:____________________________________________________________ Email: _ ___________________________________________________________ ABF: _ _______________________________ Contact No:____________________ Do you require special seating? Yes No Seating details:______________________________________________________ Total Amount: $ _ ______________ Card Type: Mastercard Visa Card Holder’s Name: _ _____________________________________________ Card No: _ _____________________________________________ Expiry Date _____ _____ / _____ _____ Card holders signature: _ _____________________________________________ How to Enter Entries and payments can be made online or by mailing pages 5 and 6. Mail Pele Rankin Gold Coast Congress Entries 38 Kirkdale Rd, Chapel Hill Qld 4069 Online myabf.com.au/events