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Skippers Course Booking Form

skippers course booking form

Wherever you see the "*", please note that it is then a compulsory field and data has to be entered.
 

skippers course booking form
NAME & SURNAME *
ID NUMBER *
POSTAL ADDRESS * (Remember town name and postal code)
HOME TELEPHONE *
MOBILE NUMBER *
WORK TELEPHONE
FAX NUMBER
EMAIL ADDRESS *
CHOOSE YOUR COURSE CATEGORY *
Category B (15-40nm)
Category C (5-15nm)
Category D (1-5nm)
Category E (1nm)
Category R (lagoons, estuaries, harbours and inland waters)
DO YOU WANT TO ... *
I want to book for the Course on 4 September 2010
I want to book for the Course on 9 October 2010
Please let me know when the next course will be held?
BANKING DETAILS
Method of PaymentEFT payment
BankABSA
BranchStellenbosch
Account NamePA Welgemoed
Account TypeSavings
Account Number9218214935
Please put down your Initials and Surname as reference.
SECURITY CODE
Please enter the code in the space provided below. It is needed to protect this page against SPAM engines.


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