CENTENARY BALL Centenary Ball - Saturday 1 July Please fill out all fields below. You can apply for yourself only or a table of up to 10. Tickets cost £100 per person. Payment options are listed at the end of the form. Note that tickets will not be confirmed or issued until full payment has been made. Name * First Last Phone (preferably mobile) * Email * I am a(n)... * OP Current Parent POP / Former Parent Staff Former Staff Governor / Former Governor Other (Please Specify) If more than one category above applies to you, please add additional categories here. Are you booking for yourself? * yes no How many tickets are you booking? * One, for myself One, for someone else Two, for a couple 10 - an entire table Other (please specify number) If you are booking for more than yourself, please include the FULL NAMES of all those included in this booking. * Please enter N/A if only booking yourself. Note that names on this booking form will be used to create table plans. Dietary requirements (if applicable) Access requirements (if applicable) I will pay by... * Cheque, made payable to 'Pangbourne College' Bank transfer, please send me details Credit / Debit Card Staff Place Once you have completed this form, please press submit. Note that tickets are not confirmed until full payment has been made. If choosing credit/debit card, please ring Anne Huddart between 09.00 and 15.00, Monday to Friday, to complete your payment: 0118 976 6795.