Social Events Registration If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required If more than one person is registering on this form, both must be registering for the same nominated event(s). If this is not the case, separate registrations must be submitted for each person. . Number of registrants (maximum of 2) * First registrant - given name and surname * Second registrant (if applicable) - given name and surname Your email * Your phone number * Select at least one of the following events to register. Multiple selections are permitted: * Christmas Lunch - 19 December - $65.00 pp Piemonte Cafe - 23 January 2020 - $33.00 pp Any additional information you believe will be useful to the event coordinator including dietary requirements (if applicable): Anti-spam question... what is 13 minus 6? Enter the answer in numerics * If you subsequently decide to withdraw from an event, please inform the event coordinator. If you wish to pay by EFT when payment becomes due, please follow these steps: Account name: Combined Probus Club of Belrose Inc Bank: Westpac BSB: 032 123 Acct: 32 5864 When making your EFT payment(s) ensure your surname is included in the “remitter” field and the function name(s) is/are included in the “reference” field. If you are registering for more than one event, you may need to make a separate EFT payment for each event because the bank’s “reference” field may not be large enough to record more than one event. Print a copy of the bank transaction receipt(s), place it/them in an envelope with your name & the function name(s) on the front and give the envelope to the social events coordinator, Liz Pawsey.