Jack Kane Dinner 2019
To RSVP please fill out a form for each attendee.

Date: 2nd March 2019
Time: 6:30 PM for a 7:00 PM start.

Event Location: Liverpool Catholic Club
Event Address: 424/458 Hoxton Park Rd, Prestons NSW 2170

Payments must be made by CHEQUE or DIRECT DEPOSIT

BEFORE 23/02/2018 to the following bank account:

Account Name: NSW Democratic Labour Party
BSB: 032-075
Account Number 513 878

For further information please contact us at:
04 9041 3672 OR nswsec@dlp.org.au

Can you attend? *
What is your title? *
Mr, Mrs, Miss, etc.
Your answer
What is your first name? *
Your answer
What is your last name? *
Your answer
Any dietary requirements?
Gluten Free, Vegetarian, etc.
Your answer
What is your phone number?
If you would like to hear from us again.
Your answer
What is your email address?
If you would like to hear from us again.
Your answer
Would you like to join our mailing list?
How did you hear about this event?
Comments / Questions
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service