Highland Ball : Application Form

Please send me .......... Tickets @ £24.00 ............ Tickets @ £26.50 TOTAL COST £...........

I enclose a cheque/P.O. For this amount made payable to “RSCDS Newcastle & District Branch”

and an A5 S.A.E.

Name/s of members ........................................................................................................................

Name/s of guests ............................................................................................................................

I/We would like to sit near ...............................................................................................................

Special diets needed : ...................................................................................................................

Please return this form with the SAE and your remittance by 1st November 2006 to
Dr. P. Avery, 8, Queens Terrace, Jesmond, Newcastle NE2 2PL