AQHA Magazine July August 2019 AQHA July-Aug 2019 Final | Page 64
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AQHA
MEMBERSHIP
RENEWAL
2019 AQHA
Awards Night
SATURDAY 12th OCTOBER 2019
6:00pm for 6:30pm
VENUE: Pullman Melbourne
Tickets - $75 Adults • $35 Children 12yrs & under
TICKETS INCLUDES: Dinner Awards Presentation
& Entertainment. Dress Smart Casual.
I wish to purchase
• Adult Tickets @ $75.00:
(No.) _______________
• Children Tickets @ $35.00:
(No.) _______________
List of people I am purchasing tickets for:
_________________________________________________________
_________________________________________________________
DU G E U : ST
_________________________________________________________
_________________________________________________________
1ST AU
2019
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
I wish to be seated with:
__________________________________________________________
TO RENEW ONLINE:
• www.aqha.com.au
• Online Service
• Membership Renewals
• Online Membership
Renewal 2019/2020
If you have trouble please phone
the AQHA Office - 02 6762 6444
__________________________________________________________
__________________________________________________________
I am collecting Awards for (other than your own):
__________________________________________________________
Name: ___________________________________________________
Membership Number: _______________________________________
Contact No: _______________________________________________
Email: ____________________________________________________
Any Special Dietary Requirements (please circle) YES NO
Details if seafood allergy, gluten intolerant etc.
CREDIT CARD DETAILS:
Name on card: ______________________________________________
Credit Card Number: ________ / ________ / _________ / ________
Expiry Date: _______ / _______
Signature: ____________________________________________
Forms can be faxed to 02 6762 6422
or email to [email protected]
AUSTRALIAN QUARTER HORSE ASSOCIATION