Stage 1 - Credit Union Level

Credit Union Registration Form
Receipt of this form ensures that you are registered for the quiz and
that your Quizmaster is sent a set of questions for the appropriate day.
PLEASE COMPLETE ALL IN BLOCK CAPITALS

* 1. Name of Credit Union:

* 2. Credit Union email Address - required (needs to be different to Quizmasters email)

* 3. Chapter number:

* 4. Quiz Masters Name:

* 5. Quiz Masters Address:

* 6. Quiz Masters Email Address (required to receive quiz question amends):

* 7. Quiz Masters Telephone Number:

* 8. Quiz Co-ordinators Name:

* 9. Quiz Co-ordinators Telephone Numbers:

* 10. *Proposed Date of Quiz - Must be held on one of the following days

* 11. Location & address of quiz?

* 12. No. of teams Expected (For statistical info. only) :

* 13. Public Liability Insurance: The above details are sufficient notice to the ILCU of the credit union holding the Quiz outside of the normal premises.  However, if your credit union requires evidence of public liability cover, please confirm by ticking the relevant box:

* 14. Do you have more than 20 primary schools operating within your Common bond, and do you think these 20 primary schools will be participating in the Quiz, please confirm by ticking the relevant box

* 15. Posters: Please state number of posters required:

*THE DATE OF THE QUIZ CANNOT BE CHANGED.

THIS FORM TO BE COMPLETED BY THE CREDIT UNION NO LATER THAN MONDAY 9TH JANUARY 2017

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