Please complete as appropriate Total Total

Table(s) @ £500 per table of 10

Ticket(s) @ £50 per person

£ .

£ .

£ .

£ .

Enclosed Payment of

Enclosed Sponsorship Donation of

* Donation to Children in Crisis or sponsorship donation is NOT necessary to take part in the quiz, and will NOT count towards ticket/table payment.

I Enclose a Cheque made payable to Children In Crisis (Tickets) or Archbishop Tenison’s School (Sponsorship Donation)

Please Debit my Credit/Debit card details:

Card No. Card Security No.

Start (MM/YY) End (MM/YY) Issue No. (Where applicable)

Name:

Email:

Phone No,

Mobile No.