Humber Branch Annual Dinner & Dance

Booking Form

o  Friday, 9 October 2015

o  Forest Pines Hotel and Golf Resort, Ermine Street, Broughton, Brigg DN20 0AQ

o  Reception at 7.00 pm - Carriages at 2.00 am

o  Dress: Black tie

Contact Details

Company/organisation
Contact name
Position
Telephone
Email address

Tickets

Number of tickets (tables of 10 available)
Booked & paid before
Friday, 14 August
£56.00 each
Booked after 14 August*
£61.00 each

*Payment required by Thursday, 24 September

Bookings of less than 10 tickets will be seated at tables of 10

Invoicing Details

Name
Telephone
Email address
Purchase order no.
Postal address
(including postcode)

Sponsorship Opportunities

The following sponsorship opportunities are availability but are on a first come first served basis. For more information, please contact Tim Brant -

Sponsorship Package / Cost / Would like to sponsor?
ARRIVAL DRINKS (may be shared with other Companies) / £1,350 / Yes/No
CASINO / £250 / Yes/No
CHARITY RAFFLE – raffle prize donations welcome (cash or gifts) / £Value / Yes/No
MENUS (with your Company logo) / SOLD / -
TABLE MAGICIAN / £100 / Yes/No
LADIES FAVOURS / SOLD / -

Signed:

Print name:

Date:

o  Once completed, please return this form with payment to:

Joanne Howard

Inter Terminals Ltd, Immingham West Terminal

West Riverside Road, Immingham Dock, DN40 2QU

e: - t: 01469 554511

o  All prices quoted include VAT

o  You will be invoiced in due course

o  Payment by cheque payable to ”Energy Institute Humber Branch” or by bank transfer

to our account: Sort Code – 30.93.68. Account no. 01904194

o  If you wish to make any changes, please inform Joanne as soon as possible

o  Please send a jpeg of your Company logo to ensure we have the correct one to

Tim Brant -

o  You are asked to provide details of any special dietary requirements no later than Thursday, 24 September to Tim Brant - or tel: 01472 851130

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