Sheet1 - UNSW Hockey Club

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					                                                  UNSW HOCKEY CLUB



                                                  UNSW HOCKEY CLUB
                                                  CREDIT CARD PAYMENT FORM
                                                      2011


Full Name
Team selected in
Have you completed a Club Registration form for 2011                          Yes              No
If No - please provide email address


                                      Payment                            Payment
                                       Prior to                         after first
Fees                                first game       x                       game      x
UNSW Current Full Time Student            $300                               $350
Alumni                                    $470                               $520
Associate Member                          $500                               $550
U17 Junior Playing Senior                 $200                               $200
U17 Junior                                $150                               $150
                                                           Place X in applicable boxes
Uniforms                                  Cost       x
Women Skort                                $25
         Skirt                             $35
         Socks                             $10
Men      Shorts                            $30
         Socks                             $10


If you wish to take advantage of our rep policy or multi child policy, please discuss with Treasurer

Total Payment due                           $0

Credit Card Details
Visa                               Mastercard
Card Number
Expiry Date

Signature
Date

Please complete form, print and sign
Email to Treasurer or provide hard copy to Fee Collector at training
whalieshockey@gmail.com

				
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posted:7/20/2011
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