Annual Retreat Booking Form

2019 Annual Retreat Booking Form

Hotel Academy Kurri Kurri NSW: 12/13-15 September 2019
Full payment due by Friday, 30 August 2019

Name*
First Last
Address*
Street Address City State Post code
Telephone:*
Email*
Current QuiltNSW individual financial member?*
- Yes
Booking*
- Two nights - Single ensuite room $595
- Two nights - Twin ensuite room $450 per person
- Two nights - Single shared amenity room $440
- Two nights - Twin shared amenity room $375 per person
- Three nights - Single ensuite room $795
- Three nights - Twin ensuite room $640 per person
- Three nights - Single shared amenity room $595
- Three nights - Twin shared amenity room $530 per person
Sharing room with
full name
Please list any special dietary requirements
Are you paying the full amount , deposit or your remaining balance
- I'll pay the full amount now
- I'll pay a deposit of $50 now
- I have paid a deposit and will now pay the final balance
Payment of Full Amount
- Two nights - Single Ensuite room
- Two nights - Twin Ensuite Room
- Two nights - Single shared amenity room
- Two nights - Twin shared amenity room
- Three nights - Single Ensuite room
- Three nights - Twin Ensuite Room
- Three nights - Single shared amenity room
- Three nights - Twin shared amenity room
Payment of Deposit
- Deposit of $50.00
Payment of Balance having previously paid deposit
- Two nights - Single Ensuite room
- Two nights - Twin Ensuite Room
- Two nights - Single shared amenity room
- Two nights - Twin shared amenity room
- Three nights - Single Ensuite room
- Three nights - Twin Ensuite Room
- Three nights - Single shared amenity room
- Three nights - Twin shared amenity room
Total
$ 0.00
Comment

2019 Annual Retreat Booking Form

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