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Farm Tree Expo 2012 Booking Form

To register for a Bushfood Picnic Hamper, or "After Dark with Shane Howard" & BBQ complete this booking form and click submit. Or download as a pdf and post it to OAN (03) 5236 2086, 55 Main Street Birregurra Victoria 3242

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Name
 
Address
 
Postcode
 
Phone
 
Email  
Comment
ACTIVITY
Number of Bushfood Picnic Hamper(s)
 
@ $20
Number of After Dark with Shane Howard & BBQ(s)
 
@ $25
TOTAL
PAYMENT OPTIONS
Cheque: make payable to Otway Agroforestry Network 
Direct Debit: BSB: 633-000, Account number: 125876102 
Credit card: we will call you back for your card details 
[If paying by direct deposit, include the reference code/comment you will use below]
 
To help eliminate spammers, please type the following code in the box below AAA52A

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