Ambassadors for Christ Dinner

Name*
First Last
Email*
Number of Tickets*
Price per ticket: $ 70.00 Quantity:
Attendee Names*
Please list the names of those who will be attending the dinner (including yourself).
Dietary Requirements
If you have any special dietary needs, please include the details here.
Payment Method*
- Credit Card
- Direct Debit
Credit Card*

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Account Name*
Account BSB*
Account Number*
Total
$ 0.00