2019 Sports and Club Class Nationals Entry Form
Payment Details
Bank: ANZ
BSB: 014-630
Account Number: 101306463
Account Name: Kingaroy Soaring
Reference you used in the payment transaction
IMPORTANT - We need this to identify the payment as yours
Pilot Details
Pilots Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Your Gliding Club
*
GFA Membership Number
*
GFA Membership Expiry Date
-
Day
-
Month
Year
Date
Next AFR Due
*
-
Day
-
Month
Year
PLEASE NOTE Annual Flight Reviews will NOT be possible during the comp including practice days.
Emergency Contact Details
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Glider Details
Glider Type
*
VH Registration
*
Comp ID
Class Entering
*
Sports
Club
Powerplant
*
Un-powered Glider
Self Launching Glider
Submit
Second Pilot (if applicable)
Second Pilots Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Your Gliding Club
GFA Membership Number
GFA Membership Expiry Date
-
Day
-
Month
Year
Date
Next AFR Due
-
Day
-
Month
Year
PLEASE NOTE Annual Flight Reviews will NOT be possible during the comp including practice days.
Emergency Contact Details
Second Pilot Emergency Contact Name
First Name
Last Name
Second Pilot Emergency Contact Phone Number
-
Area Code
Phone Number
Submit
Should be Empty: