Awards Dinner Ticket Reservation

2011 AWARDS DINNER TICKET
&
RETIREMENT CELEBRATION FOR HEATHER HOWELL
ORDER FORM

Please complete the following information and return with payment to the Ontario PGA office by clicking submit form, email to stacey@ontariopga.com or print and fax to 905-420-1226 by October 17, 2011

Name:
Email Address:
Number of Tickets Required:
Payment Type:	VisaAmexMasterCard
Credit Card Number:
Expiry:
Three or Four Digit Security Code:
Name as Shown on Card:
Credit Card Billing Address:
Total:

Individual Tickets $70 including HST
Dress: Smart Casual

Deadline: October 17, 2011
All tickets must be prepaid