Cocktails for Clover

Cocktails for Clover

Cocktails for Clover

 

Clover Moore Fundraising Cocktails

Parliament House Thursday 28 October    RSVP by Friday 15 October 2010

 

My Details

Name:

 

Street Address:

 

Phone:

 

Email:

 

If you purchase tickets or make a donation you must provide your full name and street address

 

YES, I’ll be there

How many tickets?

 

 

Guest name(s)

   
    

Can’t make it, but….

I want to make a donation to Clover’s election campaign

 

Yes

 

No

How will you be paying?

Cheque or Money Order(Enclosed)

Amount:      $

Visa / Mastercard/BankCard (Please circle)

Card No:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Expiry:

 

Name on card:

 

Amount:

 

Signature:

 

 

 

     

Return to: Clover Moore 2011 Election Fundraising

Mail: PO Box 600, Surry Hills NSW 2010   email: rsvp@clovermoore.com

Fax: (02) 8212 8948 or call Kay 9331 6412 on to book over the phone or for more information