Wessex Wishes

Christmas Dinner & Disco

First name

Last name

Email

Phone

Number of Tickets required

Amount payable @ £40 per ticket

Cheque by post to; Mrs F Cornelius, 5 Woodhouse, 10 The Avenue Poole BH13 6AG

Bank Transfer to: Wessex Wishes Ltd Sort 60-16-04 Acc 74403907

Creit Card Via/Mastercard

Please provide Name on Card, Card Number, Expiry date, Security code (information held in compliance with Data Protection regulations)

Number of Honeydew Melon

Number of Parsnip soup

Number of Lamb

Number of Bream

Number of Mushroom Pie

Number of Lentil Nut Roast

Number of Apple/Rhubarb Crumble

Number of Chocolate Fudge Cake