ENTRY FORM

( ENTRY CLOSES 23 MAY 2010)

YORKSHIRE AND HUMBERSIDE CIVIL SERVICE SPORTS COUNCIL NATIONAL QUALIFIER

VENUE:

HULL GC

ENTRY FEE £50

DATE:

MONDAY 14th JUNE 2010

NAME:

CSSC NO:

DEPARTMENT:

CONTACT ADDRESS:

TELEPHONE No:

E-MAIL ADDRESS:

HOME ADDRESS:

HANDICAP:

GOLF CLUB AND ADDRESS OF CLUB:

SIGNATURE OF COMPETITOR:

ENTRY FORMS RETURNED TO :

STEVE BRATTAN

10 HAMPTON CLOSE CLEETHORPES N E LINCS

TEL:01472 622533 MOB 07931594490

E-MAIL steve.j.brattan@voa.gsi.gov.uk

CHEQUES PAYABLE TO S J BRATTAN.