Register For The Thiess 2009 Charity Ball

Your Contact Information

Name Company Postal Address Suburb State QLD NSW ACT VIC SA WA TAS NT Postcode Phone Email

I would like to book tickets for Thiess' 2009 Charity Ball - le WINDMILL de ROUGE

tickets at $160 per person inclusive

tables at $1600 per table of ten

or

I am unable to attend, however I'd like to make a

donation to the Hear and Say Centre for $.00

I would like to pay upon

Invoice
Please contact me for credit card payment

If paying by credit card, please supply the name of the person to contact

Name Contact No

 

 

Thank you for your booking and for your support of the children of the Hear and Say Centre.