CORO CLUB LIMITED trading as

ABN 76 001 071 245

RIVERINA FIELD DAYS

2012 APPLICATION FORM (May 11 & 12)

TAX INVOICE

 

Company/Business Name ………………………………………………………………..

Address: ………………………………………………………………………………….

Town: ……………………………………..State  ……………….. Post Code ………….

Phone (       )……………………. Fax: (           )………………….Mobile ………………

Email Address:……………………………………………………………………………

Website (if applicable)  WWW…………………………………………………………..

Principal Contact:  …………………………………… Date: …………………………..

 

Indicate site and other requirements below: (Please tick appropriate box)

           NON POWERED SITES

[    ]

20m x 20m site @ $800                                 } Main

$

[    ]

Extension on 20m x 20m sites only @ $220 } Arena

$

[    ]

20m x 10m site @ $660 (limited number)

$

[    ]

10m x 10m site @ $600

$

[    ]

  5m x 10m site @ $300

$

[    ]

  6m x 6m site @ $216 }    General Interest inside fence on

$

[    ]

12m x 6m site @ $432 }    main arena – no power available

 

$

[    ]

20m x 10m site @ $660 (limited number)    }Outside arena

$

[    ]

10m x 10m site @ $600                                }on main road

$

[    ]

  6m x 10m site @ $360                                }

$

 

 

 

[    ]

  4m x 8m site   @ $192                   } All these sites are

$

[    ]

  5m x 8m site   @ $240                   } between trees

$

[    ]

  8m x 8m site   @ $384                   } on the southern end

$

[    ]

  9m x 8m site   @ $432                   } backing onto the

$

[    ]

 10m x 8m site  @ $480 (one only)    } arena.

$

[    ]

 15m x 8.5 m site @ $600 (one only) }

$

 

 

 

 

POWERED SITES – GENERAL INTEREST AREA        

Power Extra

[    ]

12m x 6m site   @ $432

$

[    ]

14m x 6m site   @ $504

$

[    ]

10m x 10m site @ $600 (one only)

$

[    ]

[    ]

[    ]

  6m x 6m site   @ $216

  7m x 6m site   @ $252

  7m x 10m site @ $420

$

$

$

 

  Larger sites may be possible by combining sites – please ask

 

 

[    ]

10m x 10m site @ $600  }    Rural exhibitors – Bar side

$

[    ]

20m x 10m site @ $660  }    We may be able to accommodate

$

[    ]

  5m x 10m site @ $300  }    larger sites if required.  Please apply

$

 

[    ]

 

Electricity for outdoor sites @ $60  (supply your own leads)

 

$.........................

[    ]

Woodside Hall  - Specify site size & cost (See P10 )

 

 

$.........................

[    ]

Davidge Pavilion  - Specify site size & cost (See P10 )

 

 

$.........................

[    ]

 

W.G.M.B. Marquee (Rural exhibitors only) – Specify site size & cost (See P?? for information and eligibility)

 

$.........................

[    ]

Trestles (available from RFD in Woodside Hall & Davidge Pavilion only) @ $15 each

 

$.........................

 

[    ]

Electricity in Woodside Hall, Davidge Pavilion  & WGMB Marquee, F.O.C. (supply your own leads and double adaptors).  Why required………………..aH

 

$.........................

 

OTHER REQUIREMENTS

 

[    ]

Hay Bales  [             ] @ $5.50.  (Hired not bought) (Outside only)

 

$.........................

 

 

 

[    ]

Passes:   Please indicate total number required [         ].  You may have up to 2 free but any additional ones will incur a charge of $5 each.  [           ]   required at $5 each. Each pass admits one person. Please ensure you purchase the correct number..

 

 

 

$.........................

 

 

 

 

TOTAL PAYMENT DUE:                (GST INCLUSIVE)

 

$.........................

 

 

 

           PUBLIC LIABILITY.  Please complete the following information         Please complete the following information

          DO NOT SEND A COPY OF YOUR POLICY             

 

           Insurance Company………………………………….

           Amount of Cover   $ …..…   million..

           Policy Number ……………………..

           Renewal Date ………………………

           If these details are not supplied we will be unable to accept your application

 

I confirm that all the details on this Application are correct and that I have read the Foreword and    understood all the Conditions in the Prospectus.  I also advise that if the Public Liability Policy is due for renewal prior to the RFD that it will be renewed..

 

 

            ……………………………                       ……………………..

            Signature of Exhibitor                                Print Name

 

PLEASE FORWARD CHEQUE (payable to Coro Club Limited)  FOR FULL AMOUNT WITH APPLICATION FORM  TO:

 

  Riverina Field Days Pty Limited

PO Box 2265, Griffith.  NSW    2680

Register by email to:  riverinafielddays@bigpond.com

 

WE ALSO ACCEPT DIRECT BANKING:-

Account Name: Coro Club Limited;   Bank:  ANZ,   BSB:  012-657,

Account No. 4978-80049.  Please include Company Name as Reference.

 

WE WILL ALSO ACCEPT CREDIT CARD PAYMENTS

 

  Upon completion of this form it becomes your Tax Invoice for payment purposes.  Please keep a copy for your records, however you will receive another Tax Invoice marked PAID after payment is received.