| NAME: | |
| CALL SIGN: | |
| HOME PHONE: | |
| BUSINESS PHONE: | |
| E-MAIL ADDRESS: |
| QTY. | DESCRIPTION | TOTAL: |
|---|---|---|
| TABLES AT $ 8.00 EACH = | ||
| TAILGATES AT $ 6.00 EACH = | ||
| ADDMISSIONS AT $ 6.00 EACH = | ||
| TOTAL: |
Make all cheques payable to:
Brantford Amateur Radio Club
P.O. Box 25036
Brantford, On. N3T 6K5
| SPECIAL REQUESTS |
|---|
| BARC USE ONLY |
|---|