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Annual Alumni Dinner 2012 Booking Form

Your E-Mail Address (Required)

Title (Required)

First Name (Required)

Surname (Required)

Subject (Required)

Year (Required)

Address, including post code (Required)

Phone Number (Daytime) (Required)

Number of places/tables you wish to reserve (Required)

Guests' Names (and Subject/Year if applicable)

Is there anyone that you wish to be seated with?

Comments and Special Dietary Requirements

Payment Options (Required)

I have sent a cheque in payment for my tickets
Please ring me to arrange payment by credit/debit card
I will ring you to arrange for payment by credit/debit card (Telephone 0116 252 2418)

How did you hear about the Alumni Dinner 2012? (Required)

Alumni Website

Facebook page

LinkedIn group

Friend/Recommendation

Invitation Letter

If you have a Offer Code please enter it below:

We will be pleased to offer a full refund within 7 days of booking. After the 7 days, due to the nature of the event, all ticket sales are final.

Data Protection

All information is held securely by the University of Leicester and will be treated confidentially. The information you provide will be used to keep you informed about the Alumni Dinner and other related University developments, events, products, services and fundraising which may be of interest. Data will not be disclosed to external organisations or individuals, other than those acting as agents for the University. For further information please contact us at our Office address.

Please note: due to high demand for this event we must receive payment for tickets within 14 days of booking otherwise we will re-release them for sale.