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Booking Form

Cost of the Continental breakfast is $30 and entry is only by pre-purchased ticket.
Payment can be made by cheque, money order, credit card or direct debit.

Contact Marilyn Newham 6231 1344 for information on direct debit payments.
Cheques and money orders to be made payable to IWD Breakfast and payments must be received by Friday 29th February 2008

Return this form with payment and a STAMPED
SELF ADDRESSED ENVELOPE for return of your tickets to:

IWD BREAKFAST
PO Box 1094
Tuggeranong DC ACT 2901
___________________________________________
BOOKING FORM
Name: ………………………………………..
Address: …………………………………….
……………………………………………….
Tel: ……………(W) ……………………(H)
Enclosed is a cheque/money order for $......
for ……………….tickets
Credit Card details: Type of Card ……….
Name on Card ……………………………..
Number ………../………./………./……….
Expiry Date ……../…………..
Signature ………………………………