Entry Form

 

Name of Entrant: _____________________________

Passenger 1:________________________________

Passenger 2:________________________________

Truck Make_____________________Year________

Model______________________Rego___________

Date of intended start__________ Finish__________

Contact Number_____________________________

Mobile: ____________________________________

Email address: _______________________________

____________________________________________

Postal Address________________________________

____________________________________________

CB Radio Yes / No circle which applicable

Entry fee of $150 payable - please include it with this form. Please complete one entry form per vehicle.

 

 

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North Classic Commercials 1372 State Highway 56 RD7 Palmerston North

New Zealand Classic Commercials North Island Long Lap