DINNER BOOKING FORM
To confirm your attendance at the awards dinner, please complete this form and return it with payment to: Lizzie Dekkers, Interactive Marketing & Advertising
Awards 2004, C/o Centaur Events, St Giles House, 50 Poland Street, London, W1F 7AX or fax the form with your credit card details to 020 7970 4797
Wednesday 10th November, Royal Lancaster Hotel, London
Table of 10 tickets; £1,295 + VAT (£1,521.63)
Individual places; £145 + VAT (£170.38)
Please reserve ________ group(s) of ten or ________ place(s)
CONTACT DETAILS
Contact Name
Job Title
Company Name
Address
Postcode
County
Telephone
Fax
Email
Signature
PAYMENT DETAILS
I
I
I enclose a cheque made payable to Centaur Events for £__________
I
I
Please debit my credit card by £__________
Please note billing address must be the same as mailing address
I
I
Access
I
I
Amex
I
I
Switch
I
I
Visa/Mastercard
Card Number
Name on Card
Issue Number (Switch only)
Valid Date
Expiry Date
Signature
Date
Bookings will remain provisional until receipt of a completed booking form plus full payment. Tickets will be forwarded approximately two weeks prior to the event. Cancellations will be accepted and monies refunded less a 20% administration
fee up to and including 9th October 2004. No refunds will be made after the 9th October 2004.
We would like to keep you up to date with relevant Centaur products and services including information about forthcoming events. Please write to the Circulation Director at St Giles House, 50 Poland Street, London, W1F 7AX if you
specifically do not want to receive this information.
