TAR Dinning Memorial Neurosurgical Scholarship Launch

Sunday 18th April

Grand High Tea
1pm - 4pm
Incl. wine, beer, soft drink, tea and coffee, and sweet and savoury courses

Purchase Options	Quantity
High Tea Ticket ($120)

You have selected x tickets at a cost of $x

Your Information

First name

Last name

Email address

Mobile/Phone number

Your Address

Line 1

Line 2

City

State

Postcode

Country

Credit card details

Accepted cards

Card holder name

Card number

Expiry

Year

CVV

Special Assistance

Do you or anyone in your group need any assistance? If so, please let us know how we can help...

Dietary Requirements

Do you or anyone in your group have any dietary requirements? If so, please let us know how the details...

Donation

Would you like to add a donation to your purchase?

Donation amount

Please tick the checkbox if you do not wish to receive future marketing emails. I would like to help further by including transaction fees with my payment.