EmailMe Form - POTJIEKOS KOMPETISIE / POTJIEKOS COMPETITION

Naam / Name *

Van / Surname *

Fisiese Adres / Physical Address *

Voorstad / Suburb *

Stad of Dorp / City or Town *

Poskode /Postal Code *

Tel (H)

Tel (W)

Sel / Cell *

Epos / Email *

Fax

Naam van Span /
Team Name *

Kaptein / Captain *

Antal mense in span / Number of members in Team:
(Neem asseblief kennis dat spanne nie meer as 4 lede mag hê nie/ Please note that teams are not allowed to have more than 4 members) *

Tema / Theme: *

Tipe Potjie / Type of Potjie: *

Vleisbenodigdhede/ Meat Ingredients:
(Neem kennis dat Meat World slegs die vleis (totaal 2kg) vir u potjie sal skenk, maar dat u alle ander bestanddele self moet bring / Please note that Meat World will only donate (total only 2kg) the meat for your potjie, but that you will have to supply all other ingredients.) *

Tipe Vleis / Type of Meat *

Aantal Kg / Number of Kg *

Hoe moet vleis gesny wees? / How must meat be cut? *

Bykosse/ Additional Dishes:
(Neem kennis dat elke deelnemer ten minste een bykos moet voorberei saam met die Potjie. Please note that entrants must prepare at least one additional dish to be served with your potjie) *

Ek het die reëls gelees en onderteken en deur vir hierdie kompetisie in te skryf, onderneem ek om die reëls van die kompetisie na te kom en te eerbiedig. I read the rules and signed every page. By entering this competition, I undertake to adhere and to respect the rules of this competition.
Vul die vorm in, parafeer die reëls en beoordelaarsvorm. Faks of epos die inskrywingsvorm, getekende reëls, beoordelaarsvorm en inbetalingstrokie:

Please fill in the form, initial the rules and judging form.
Fax or email the entry form, signed rules, judging form and proof of payment:
Faks/ Fax: (011) 362 5233
Epos/ Email: admin@lefra.com

Betaal die inskrywingsfooi van R250 in die volgende rekeningnommer. Please pay in the entry fees of R250 in the following bank account:
Lefra Kommunikasie en Bemarking/ Lefra Communications and Marketing
ABSA Spaarrekening/ ABSA Savings Account
Takkode/ Branch Code: 501 – 642
Rekeningnommer/ Account Number: 288 167 133
Verwysing/ Reference: Potjie Your Name and Surname; Title of Team
Epos betalingstrokie aan/ Email POP to: admin@lefra.com

Aanvaar / Acccept *

Ek aanvaar dat al die begenoemde informasie korrek is / I accept that all of the information above is correct.