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THE MAYORESS'S BALL
Application for Tickets
Please complete this form and make your payment by EFT
Langeberg Hospice
Standard Bank
Swellendam branch 2800 124 11
Reference: Tickets for Ball
Send proof of payment to hurdlesone@gmail.com
Name
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First
Last
Email
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Phone
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Number of Tickets required
Number of Vegetarians
Comments or queries