SORRY, THIS EVENT IS SOLD OUT
Print and complete this form and mail or fax to address below
No children under 12 years of age. Last ticket sales 5th March 2008. No refunds.
To book a Prime Table (near the dance floor), or to benefit from the Sponsors' packages, please refer to the sponsorship form.
Full price tickets
Under 30 yrs of age
Complete tables of 12
£180
£110
£160 per seat & £100 for U30s
_____ I / We wish to purchase _____ tickets at £180
_____ I / We wish to purchase _____ tickets at £160 (table of 12)
_____ I / We wish to purchase _____ tickets at £110 (U30s)
_____ I / We wish to purchase _____ tickets at £100 (U30s table of 12)
I / We _______________________ enclose a payment of £_________
Payment method:
____ Cheque (payable to Iran Heritage Foundation)
____ Credit Card Amex, Visa, Mastercard
Credit Card No.
_______________________________________________
(we will contact you for the security code)
Expiry date
_______________________________________________
Name on the card
Title_____First____________Last ___________________
Card Holder's Address
_______________________________________________
City
_______________________________________________
County/State
_______________________________________________
Post/Zip Code
_______________________________________________
Country
_______________________________________________
Signature
_______________________________________________
Name and address where tickets should be mailed to
Name
Title_____First____________Last ___________________
Address
_______________________________________________
City
_______________________________________________
County/State
_______________________________________________
Post/Zip Code
_______________________________________________
Country
_______________________________________________
Tel
_______________________________________________
Mobile
_______________________________________________
Fax
_______________________________________________
E-mail
_______________________________________________
Please name your guests below. You should indicate the age of guests under 30 years of age. Please indicate if you would all like to sit together or you leave it to our discretion to seat you according to age.
You may indicate if you would like to be seated with friends who will be buying seats separately.
No
Title Full
Name
Age if under 30
1
2
3
4
5
6
7
8
9
10
11
12
Complete and return to:
Iran Heritage Foundation, 5 Stanhope Gate, London W1K 1AH
Tel +44 20 73062060, Fax +44 20 74999293
info@iranheritage.org, www.iranheritage.org
Charity Number 1001785
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