SURNAME

STATE POST CODE

ACTA No.
CONTACT No.
Please circle your Grade and Section ( if applicable) HANDICAP
Date of birth
A B C LADIES
/ /
LADIES
JUNIOR
OPEN
1. 25 Tgt Handicap $16.00 $22.00
2. 25 Tgt Double Barrel $16.00 $22.00
3. 25 Tgt Single Barrel $16.00 $22.00
4. 25 Tgt Points Score $16.00 $22.00
TOTAL
Payment Method:
CASH CARD CHEQUE
Post your Nomination and Cheque/Money Order to Date Received
SOUTH EAST ZONE, 18 VENICE STREET MORNINGTON, VIC 3931
By signing I agree to abide by the conditions of the South East Zone Rules.
Rules available on Melbourne Gun Club Website. ( www.melbournegunclub.com.au )
Signed: Date:
Shooter Non-shooters
YES / NO No. ATTENDING
Please make out Money Orders/ Cheques to
SOUTH EAST ZONE GUN CLUB INC.
MONEY ORDER
VETERAN
JUNIOR
EMAIL
All nominations are fully refundable if unable to attend.
Late nominations will incur a $20 per event fee.
There will be a light dinner after presentations at a small cost, please indicate below if you will
be attending and how many. Shooter FREE, Non-Shooter $10.00.
Pre - Nomination must be lodged with the South East Zone by Close of Business on the 27th of August 2014.
SOUTH EAST ZONE TRAP CARNIVAL 2014
SATURDAY 6th SEPTEMBER 2014 9AM START CONDUCTED AT
MELBOURNE GUN CLUB, 192 Victoria Road, Yering.
Melways 274 E9
PRE - NOMINATION FORM
AA
FIRST
NAME
ADDRESS
SUBURB
CLUB