Dr Phillip Law ANARE Club Members Tribute - Friday April 23rd, 2010 2.00pm

Name......................................................................................Phone..............................                                 Postal Address.........................................................................Postcode........................

Certified no Club use only

Confirming attendance...........$20     Enclosed $...............   

Cash / Cheque / Card

Name on Card................................................. Expiry date...............



Signature.............................................................................

Credit card bookings may be faxed to 03 5367 4008 or

scanned and sent to:

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