Valentines Masquerade Ball champagne reception 3 course meal live entertainment fireworks For all st

1
Valentines Masquerade Ballchampagne reception3
course meallive entertainmentfireworks For
all staff of NUH and their partners Saturday
February 14th8.00 pm65
Tickets on sale Now

• In aid of the QMC Paediatrics Department and the
  Kenyan Orphan Project
• For more information contact Rakhee Shah on 07828
  697 832 or mzyzrs_at_nottingham.ac.uk

2
Valentines Masquerade Ballchampagne reception3
course meallive entertainmentfireworks For
all staff of NUH and their partners Saturday
February 14th8.00 pm65

• In aid of the QMC Paediatrics Department and The
  Kenyan Orphan Project
• For more information contact Rakhee Shah on 07828
  697 832 or mzyzrs_at_nottingham.ac.uk

To book a table for the Valentines ball on
14/02/09 please fill in the form below and return
to the KOP box in the Medical School Faculty
Office, B Floor, QMC or post it to Rakhee Shah,
15 Heron Drive, Nottingham, NG7 2SD, your tickets
will be delivered to you. Tables are limited to
10 persons, but if you would like a larger or
smaller table this can be accommodated
for. Name Special Dietary
Requirements 1. __________________________________
_____________ __________________________________
_ 2. _____________________________________________
__ ___________________________________ 3.
_______________________________________________
___________________________________ 4.
_______________________________________________
___________________________________ 5.
_______________________________________________
___________________________________ 6.
_______________________________________________
___________________________________ 7.
_______________________________________________
___________________________________ 8.
_______________________________________________
___________________________________ 9.
_______________________________________________
___________________________________ 10.
______________________________________________ _
__________________________________ 11.
______________________________________________ _
__________________________________ 12.
______________________________________________ _
__________________________________ I enclose a
cheque/ cheques made payable to The Kenyan Orphan
Project to the sum of __________ Name
_______________________________, contact number
_______________________________,
Dept__________________ Home Address_____________
__________________________________________________
___________________________________