| Name: |
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| Postal Address: |
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| Suburb: |
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| Mobile Phone: |
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| Phone Number: |
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| Email: |
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| Are you currently involved in racehorse ownership within Qld: |
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| If you were to become involved where would you like your horse trained: |
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| What type of ownership are you interested in? |
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| Would you prefer to: |
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| Would you prefer to pay fees: |
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| What would be your preferred annual expenditure? |
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