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EFI PERFORMANCE TRACK DAY

APPLICATION FORM
 
 
Name:    
 
   
Address:    
 
   
 
Contact:    
Mobile:  _____________________________________________________________________  
   
Email:  ______________________________________________________________________  
 
Rego  No.:    
 
   
Make/Model:    
 
   
Engine:        
Ø 4cyl   Ø 10cyl  
(please  circle)      
Ø 6cyl   Ø 12cyl  
   
Ø 8cyl   Ø Rotary  
Induction      
Ø NOS   Ø Turbo  
(please  circle)      
Ø Supercharged   Ø N/A  
Event:      
Ø Cruise  sessions   Ø Off  St  drag  racing  
(please  circle)      
  Ø Circuit  sessions   Ø Go  to  Whoa  

Entry Fee – EFI Perform ance Track D ay


FRID AY 17 th JUNE 2011 (8am -5pm )
• First 100 entries @ $150.00
• Last 50 entries @ $200.00
(Includes 1 Driver Pass, 1 Vehicle Pass & Insurance)
(Pit crew and spectators free)

Account  Details  
Account  Name:  EFI  Performance  
Bank:  National  Australia  Bank  
BSB:  084  -­‐  572  
Account  No.:  85  –  817  -­‐  3121  
***NOTE:  When  making  payment  please  put  your  full  name  as  reference.  
EFTPOS/Credit  card  facilities  also  available  
 
 
EFI  Performance  
Unit  3/15  Emeri  Street  
STAPYLTON  QLD  4207  
Ph:  3801  8075  
Fx:  3801  8076  
E:  info@efiperformance.com.au  
 
 
***  Please  note  EFI  Performance  Track  Day  is  a  private  event  by  invite  only.  Organizers  of  this  event  have  the  right  to  refuse***  
entry.  All  entries  have  to  be  approved.  
 

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