Tickets
Tickets are now sold out! All applications will be added to the wait list.
Please remember that by submitting this application, you are committing to pay for the number of tickets requested; proceeds will be going to charity.
Name:
Miss
Mrs
Ms
Mr
Dr
Prof
Status:
Student
Academic/Visiting Fellow
Life Member
Other
If checked other, please specify:
E-mail address:
Phone number:
Number of Gala tickets:
1
2
3
4
5
x £ 15
I would like to make an additional donation of:
£ 2
£ 5
£ 10
£ 20
Other:
Comments/Special Requests:
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