| ENTRY FORM |
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| Autor Ante Dujić | ||||||||||||||||||||||||||||
| Ponedjeljak, 22 Ožujak 2010 12:30 | ||||||||||||||||||||||||||||
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FAMILY NAME
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CHRISTIAN NAME
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DATE OF BIRTH
EFRA LICENCE NO. / HAMS-NO.
POSTAL CODE
DATE OF BIRTH
EFRA LICENCE NO. / HAMS-NO.
POSTAL CODE
STREET
CITY
STREET
CITY
COUNTRY
CLUB
COUNTRY
CLUB
TELEPHONE
FAX
TELEPHONE
FAX
E-MAIL
HOMEPAGE
HOMEPAGE
FREQUENCY 1
FREQUENCY 2
FREQUENCY 3
2,4 GHz
AMB PERSONAL TRANSPONDER No.
FREQUENCY 1
FREQUENCY 2
FREQUENCY 3
2,4 GHz
AMB PERSONAL TRANSPONDER No.
MAKE OF CAR
TYPE OF BODY
MAKE OF CAR
TYPE OF BODY
ENGINE
TYRES
ENGINE
TYRES
RADIO
SERVOS
RADIO
SERVOS
NATIONAL RESULTS
INTERNATIONAL RESULTS
NATIONAL RESULTS
INTERNATIONAL RESULTS
DATE
SIGNATURE
DATE
SIGNATURE
Please, return the entry form filled in before May, 20th 2010 to:
Mr Ante Dujic, Mobil +385 98971 9085, e-mail: Ova e-mail adresa je zaštićena od spam robota, nije vidljiva ako ste isključili JavaScript