DINNER SHOW BOOKINGS
Please complete the following details.
Dinner places cost $120 ( Australian $ ) each.
Your confirmation will be despatched within 48 hours.

Title
First Name
Last name
Postal Address
Suburb
Postcode
Phone number ( Home )
Phone number ( Work )
Email address
Company name



BOOKING DETAILS: ( places will be reserved under the surname of the person making this booking )



Please reserve me places at "Polynesian Pavarotti Encore Dinner" with Operatif! and Ben Makisi -
Dinner Show 7th November 2008 at Court Terrace Restaurant Brisbane.

Options :
Please hold my places for 7 days while I finalise my numbers/table

Or..... PAYMENT:

I wish to pay by cheque - please call me.
I wish to pay by bank transfer- please email me details.
I wish to pay by credit card but please call me.


OR, complete your credit details now....

Credit Card Type ( VISA or Mastercard ) or :
Name on Card or :
Card Number or :
Expiry Date
Security Code ( last 3 numbers on back of card )

Special instructions ( incl Dietary Requirements )

Privacy : We undertake to keep your information secure and to not pass it on to 3rd parties for marketing.