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Allied Health Ball 2019 RSVP
Welcome to the Allied Health Ball 2019 RSVP online form
Early bird ticket price (purchased prior to 26th July): $115
Standard ticket price (purchased after 26th July): $130
Please complete the form below to register your RSVP
IMPORTANT: Your ticket WILL NOT be confirmed until payment has been verified. Payments can be made via direct debit transfer (see below)
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Email
*
Your email
Any dietary requirements please note below
Your answer
Event Details
DATE: Saturday, 21st September 2019
TIME: 7:00pm - 11pm
VENUE: Black Bird Bar and Restaurant Terrace Room
KICKON: TBC on the night
ADDRESS: Riverside Centre, 123 Eagle St, Brisbane City QLD 4000
DRESS: Formal attire
How many tickets will you be purchasing?
*
1
2
3
4
5
What are the names of people attending?
*
Your answer
What is your email address for reference?
*
Your answer
Payment Details
Name: Allied Health Ball 2019
Bsb: 923 100
Account Number: 301 309 063
Payment Reference: Last Name + First Initial
e.g. SmithA
***Important***
If you are paying for more than one person, please complete the 'Additional Guests' box above.
Please provide the full name of each guest.
I confirm I have read the above payment information. My payment reference will be: *
*
Your answer
Confirmation of RSVP *
*
I have read the payment terms and conditions.
I understand that the purchase of my ticket will not be confirmed until correct payment is verified.
Required
A copy of your responses will be emailed to the address you provided.
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