Benzing Live Privacy Declaration.

Benzing Live Privacy Declaration. [Western Pigeon Federation of Victoria]

IMPORTANT. It is mandatroy to complete all fields. Please ensure you have the Name, Address, phone number and email address of the appointed nominee. Please entre all your details and those of the person you are electing to act as your proxy.

I,(Required)

First Last

OF,(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Flying as(Required)

entre your loft flying name above

declare that.

Date(Required)

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