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10th Annual INJ Ball Ticket Order Form

Please print this out, complete all sections, using block capitals throughout and then fax it to us. Thank you.


1

Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Address ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
  ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Home Tel. ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Work Tel. ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Contact Fax ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

2

Please list the names in your group (including yourself) up to a maximum of 10 persons per table.
For vegetarian meals please circle the V column

Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V
Name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___  V

Please list the total number of vegetarians at your table here:		  ______

3

Please specify the number of tickets required:

 Number of Tickets Cost per ticket Total

 ______
at Yen19,000
Yen ____________

 

4

 Please transfer the total to the following account,
no later than Wednesday, 24 September.
Bank: Sanwa
Branch: Azabu
Name: The Irish Network
Account Type: Futsu (Regular)
Account Number: 290890

5

Please fax a copy of the bank transfer receipt with this form to the INJ :
03-3491-2465

6

Any questions? Please contact Noreen Tynan (ntynan@ptstrain.co.jp) 03-5706-4914 or
Camilla Daly (cdaly@ptstrain.co.jp) 03-3704-2457

Important!

Due to heavy demand as in previous years, tickets may be secured only by payment.

No tickets will be available for purchase at the Ball.

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