ANZAC EVE LUNCH M atch Day Pack age PERSONAL DETAILS Name: (Mr/Mrs/Miss/Ms) Company: Postal Address: Suburb: State:Postcode: Phone (mobile): E-mail: Number of Guests: @ $ 350 Match Day Package Total cost: $ (inc GST) Please tick if you require a tax invoice Method of payment (please tick relevant box): Visa Amex Mastercard Diners Bankcard Cheque Eft Please invoice please note: Amex and Diners payments incur a 4% processing fee. Mastercard and Visa payments incur a 2% processing fee. PAYMENT DETAILS Credit Card No. Expiry Date Card verification number (last three digits on back of card): Cardholder’s Name (as shown on card): I verify that I am the owner of the above credit card and I authorise Elite Sports Properties Holdings P/L to charge my card for the above purchases Signature:Date: EFT PAYMENTS Please contact ESP should you wish to pay via EFT. For any queries, please contact ESP on (03) 9421 3000 Please return this form by fax to (03) 9421 3300 or email ESP at [email protected] / [email protected] Terms & Conditions Return of this signed form constitutes a binding, irrevocable contractual commitment to purchase these tickets. A tax invoice will be issued on request. No ticket will be issued until payment is received in full. The information collected is for the purpose of placing, processing and servicing your order only. ESP respects your privacy and will not pass this data on to any third parties. ESP will keep this data on a secure database and only reuse it to notify you of upcoming ESP events that may be of interest to you. If you do not wish to receive any further information please contact us by mail at Level 4, 543-549 Bridge Road, Richmond, VIC 3121 and request to be removed from this database.