ENTRY FORM – 2013 ISPS Handa New Zealand Women’s Open (For non-ALPG members)

NAME:	Surname				First Name
Postal Address:
				Postcode
NATIONALITY/STATE/TERRITORY:
SPONSOR or REPRESENTATION:
I AM A MEMBER OF: (Please delete all those that do not apply or circle those that do)				LPGA / LET / FUTURES / JLPGA / KLPGA / Other -
MOBILE:		`		EMAIL:

METHOD OF PAYMENT

Entries for all Non-ALPG contestants MUST be made on this official entry form.Entry forms should be:

o  Emailed to Fiza Errington – fizae@alpg.com.au

o  Sent to ALPG Inc., PO Box 447, Mudgeeraba, Qld, Australia, 4213 or

o  Faxed to +61 (7) 5539 0926

Non-ALPG members MUST forward the official entry form to the above contact points. Upon receipt of entry, Non-ALPG

members will receive a confirmation of entry and payment details will be issued.

Entry fee for event is $132 (Incl. GST).

§ I understand that my entry is NOT official until receipt of payment and entry is received from ALPG.

§ I agree to be bound by the Rules and By-Laws of Australian Ladies Professional Golf Incorporated.

§ I understand that I am also liable for a one-off $200.00 Non-ALPG Temporary Member fee in addition to the above

entryfees(If I have not paid this previously).

Entry fees will not be refunded unless notification of withdrawal is received by ALPG prior to the closing date of entries. Rules of withdrawal are outlined in the ALPG Member Regulations Handbook and By-Laws (page 23).

CLOSING DATE FOR ENTRIES: 5.00pm, Tuesday 1 January 2013.

Signed:                                     Date:...............................................