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TICKET ORDER/DONATION FORM

WOMEN ONLY!

Event: The wine industry event….

Place:

Charity: Prostate Cancer

Date: Thursday 30th June 2005

Time: From 7.30pm-midnight

The Full Monty show: 8.30pm

PARTY IS OPEN TO WINE TRADE ONLY

| I would like to buy a ticket @ £27.50 per person
| I cannot attend the party but would like to make a donation

Please fill in the following information:

First Name:

Surname:

Company:

Position:

Address:

Postcode:

Tel:

Fax:

Email:

Booking terms and condition:

Please make the cheque payable to Women of Wine.

Please return your completed form with a cheque to:

Christelle Guibert

7 Meopham Road

Surrey CR4 1BH

You will receive a confirmation by email.

Tickets for the party are available on a strictly first-come, first-served basis.

Please note tickets are non-refundable.

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