Remote Area B4c Application Form

NOTE: Only the President, Secretary or Masterpoint Secretary
of the Club may apply
Full name of applicant:
Applicant's position within club: e.g. President, Secretary, Masterpoint Secretary
Applicant's e-mail address:
Date: Use 6-digits only e.g. 050602

 
On behalf of the club, details of which appear hereunder, I hereby apply for an additional three (3) B4c red points sessions for 2005.
I certify that our club is situated 40 kilometers, or farther, away from the nearest other club affiliated with the ABF.

Full Name of Club:  
Club Number:   Use 4-digits only e.g. 4532

ABF Masterpoint Centre
Revised: 15 March, 2008