Rowing ACT Season Presentation Celebration
20 October 2013 -Ticket Order Form
Note: The date for this event was recently changed.
Full Name
*
First Name
Last Name
E-mail
*
Address
*
Street Address
Street Address Line 2
Suburb
State / Province
Post Code
Phone Number
Please indicate how many tickets you would like to purchase.
*
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( X )
Yes I would like to purchase the following number of tickets, each at
$
30.00
AUD
Number of tickets required
Total
$
0.00
AUD
Would you like a tax invoice?
Yes I require a tax invoice to make the payment.
Please Provide Additional Guest Names
Additional Guest 1
First Name
Last Name
Additional Guest 2
First Name
Last Name
Additional Guest 3
First Name
Last Name
Additional Guest 4
First Name
Last Name
Additional Guest 5
First Name
Last Name
Additional Guest 6
First Name
Last Name
Additional Guest 7
First Name
Last Name
Additional Guest 8
First Name
Last Name
Additional Guest 9
First Name
Last Name
Payment Agreement
Upon submitting this form I agree to submit the specified payment .
Payment details will be provided once you have submitted your order.
Submit Order
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