Formula Ford Booking Form

FORMULA FORD COURSE - ENROLMENT FORM OR GIFT CERTIFICATE - Click here to download

Your booking may be secured by posting/faxing this enrolment form and your voucher details

Refunds are not available but you may alter your booking for a specific course within two weeks notice. Of course you will be required to sign a waiver and vehicle indemnity agreement on the day.

Full payment must accompany application forms and you may pay by cash, cheque or any of the credit cards listed below.

Your booking may be secured by sending/faxing this enrolment form and payment to us as listed below. On receipt we will confirm your booking with course joining instructions, or in the case of a Gift Certificate, a Gift Certificate. Please enrol the following person in the Formula Ford Course:

Name: ...................................................................................... Date of Course: ...............................

Address: .........................................................................................................................................

Post Code ....................... Phone: (.......)................... Mobile ........................... Email ...........................

TAX INVOICE (ABN 74141 869 669)

Voucher detalis

Voucher number....................................

I enclose cheque/money order for $...........................

I authorise you to debit my account with the following amount $......................

YOUR NAME ON CARD ...........................................................

Card No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ EXPIRY DATE ....../......./....... CVN .............

AMOUNT ...................... CARDHOLDER’S SIGNATURE ................................................

TICK CARD: Bankcard‚ Mastercard‚ VISA

To pay by direct bank debit, send monies as detailed below and put your receipt number on enrolment form:

Account Name: FFEA PTY LTD

Bank: ANZ

Branch: Chipping Norton

BSB: 012 087

Account number: 369 097 375

NATIONWIDE DEFENSIVE DRIVING SCHOOL (ABN  74141 869 669)

RTA instructors licence 012226

10 Finschhafen street, Holsworthy NSW 2173

Tel: 0430 777 000 / 1300 900 619 Fax: (02) 9825 1802 e-mail: office@finlays.com.au

OFFICE USE ONLY (Form 18/6/10):

CONFIRMED .............................................................................

PAID ............................................GST : ....................................   Corporate ............

COURSE COMPLETED ............................................................