BUS SHOPPING TOUR, Saturday 19th October 2019
          
Breast Cancer Network Australia (BCNA) will receive the entire profits.

1. Please contact Heather Christmas via text or email to book your seat/s.

2.  Payment to Geelong Touring Cyclists Inc. bank account.

Details:   BSB 063 525, Acc No 1003 4904

3.
 Please ensure your name is included with your payment and send notification of your payment to Heather along with a copy of the completed form giving the details of all the shoppers. This form is included below.

 

All communication is via text or email please to:-
HEATHER CHRISTMAS                                                                     Ph. 0431 662 799                    
                                                mtmajor196@gmail.com

1. Name……………………………………………………………………………...
Address…………………………………………………………………………..

Phone number………………………………Mobile……………………..…….
Pick up point………………………………  Amount paid……………………
Emergency Contact number………………………………,…………………...
                                                                                                                                                  

2. Name……………………………………………………………………………...
Address…………………………………………………………………………..

Phone number………………………………Mobile……………………..…….
Pick up point………………………………  Amount paid……………………
Emergency Contact number………………………………,…………………...

3.   Name……………………………………………………………………………...
Address…………………………………………………………………………. .  
Phone number………………………………Mobile……………………………
Pick up point………………………………  Amount paid…………………….
Emergency Contact number…………………………………………………….

4.   Name……………………………………………………………………………...
Address…………………………………………………………………………. .  
Phone number………………………………Mobile……………………………
Pick up point………………………………  Amount paid…………………….
Emergency Contact number…………………………………………………

Thanks for supporting BCNA